EDWARD J BLAKE Athletics Professional License verification

Business Entity

NOT RENEWED

License Type

Athletics Professional

Description

ATHLETICS - LICENSED MMA CONTESTANT

License Number

002167323-0016

License Status

NOT RENEWED

Business

First Name

EDWARD

Middle

Last Name

BLAKE

Business Name

EDWARD J BLAKE

Original Issue Date

12/20/2011

Effective Date

12/20/2011

Expiration Date

09/30/2013

City

WAUKESHA

State

Zip

53188

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/21/2013