10004282 | ASC gov

Active

Inactive

Effective Date of Credential

Tue, 09/08/1992 - 12:00

Expiration Date of Credential

Fri, 12/31/1993 - 12:00

Conforms to AQB

No

ID

291850

Certification Type

Transitional License

Address

37 TRIPLE CROWN COURT

City

BALTIMORE

State/Province

MD

Zip

21244

County

BALTIMORE

State