ROXANNE VINCENTA MODAFFERI Athletics Professional License verification

Business Entity

NOT RENEWED

License Type

Athletics Professional

Description

ATHLETICS - LICENSED MMA CONTESTANT

License Number

002166320-0016

License Status

NOT RENEWED

Business

First Name

ROXANNE

Middle

VINCENTA

Last Name

MODAFFERI

Business Name

ROXANNE VINCENTA MODAFFERI

Original Issue Date

11/23/2009

Effective Date

11/23/2009

Expiration Date

10/01/2011

City

LAS VEGAS

State

Zip

89103

County

CLARK

Ever Disciplined

LastModifiedDate

10/04/2011