DERRICK G MOON Athletics Professional License verification

Business Entity

NOT RENEWED

License Type

Athletics Professional

Description

ATHLETICS - LICENSED BOXER

License Number

002164277-0003

License Status

NOT RENEWED

Business

First Name

DERRICK

Middle

Last Name

MOON

Business Name

DERRICK G MOON

Original Issue Date

01/05/2005

Effective Date

01/05/2005

Expiration Date

10/01/2005

City

FORT WORTH

State

Zip

76137

County

TEXAS

Ever Disciplined

LastModifiedDate

10/09/2006