SHANE DERRICK ROLLER Athletics Professional License verification

Business Entity

NOT RENEWED

License Type

Athletics Professional

Description

ATHLETICS - LICENSED MMA CONTESTANT

License Number

002165983-0016

License Status

NOT RENEWED

Business

First Name

SHANE

Middle

DERRICK

Last Name

ROLLER

Business Name

SHANE DERRICK ROLLER

Original Issue Date

04/10/2009

Effective Date

05/09/2012

Expiration Date

09/30/2013

City

LAS VEGAS

State

Zip

89148

County

NEVADA

Ever Disciplined

LastModifiedDate

11/21/2013