NHCG-429 | ASC gov

Active

Inactive

Effective Date of Credential

Tue, 11/01/1994 - 12:00

Expiration Date of Credential

Fri, 12/31/1999 - 12:00

Conforms to AQB

No

ID

19251

Certification Type

Certified General

Address

PO BOX 990582

City

BOSTON

State/Province

MA

Zip

02199-0582

County

SUFFOLK

State