21PR | ASC gov

Active

Inactive

Effective Date of Credential

Tue, 07/09/1996 - 12:00

Expiration Date of Credential

Wed, 10/01/2003 - 12:00

Conforms to AQB

No

ID

190452

Certification Type

Licensed

Address

14454 SE HOLLYVIEW TERRACE

City

BORING

State/Province

OR

Zip

97009

County

CLACKAMAS

State