Details as stated in the register
- DPOR board / occupation / certificate number
- 2705136358
- Source license rank
- C
- Source specialty codes
- H/H ESC
- Source certification date
- 09/21/2010
- Source expiration date
- 09/30/2028
- Address city as filed
- FREDERICK
- Address state as filed
- MD
- Address ZIP as filed
- 21704
Register status and classifications are reproduced from the source. No independently verified business activity, customer premises, contact details, insurance or trade license is implied.