ANDREA L. MILLER Athletics Professional License verification

Business Entity

NOT RENEWED

License Type

Athletics Professional

Description

ATHLETICS - LICENSED MMA CONTESTANT

License Number

002166901-0016

License Status

NOT RENEWED

Business

First Name

ANDREA

Middle

Last Name

MILLER

Business Name

ANDREA L. MILLER

Original Issue Date

03/17/2011

Effective Date

03/17/2011

Expiration Date

10/01/2011

City

TAYLORSVILLE

State

Zip

84118

County

UTAH

Ever Disciplined

LastModifiedDate

10/04/2011