47000011362 | ASC gov

Active

Inactive

Effective Date of Credential

Wed, 08/24/2011 - 12:00

Expiration Date of Credential

Fri, 08/23/2013 - 12:00

Conforms to AQB

No

ID

248071

Certification Type

Licensed

Address

241 POINTE CIRCLE NORTH

City

CORAM

State/Province

NY

Zip

11727

County

SUFFOLK

State