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Record Last Updated: 2026-04-09
| License / Permit / Certification Number | 13523 |
| Registration Number | - |
| License / Permit / Certification Status | DISSOLVED |
| License Type | - |
| Basis for License | - |
| Issue Date | 2014-01-29 |
| Expiration Date | 2016-02-22 |
Enforcement, Non-Compliance or Disciplinary Actions | None reported to this site by the board. |
| Other Information | None |