BOARD OCCUPATION CERTIFICATE # INDIVIDUAL NAME BUSINESS NAME FIRST LINE ADDRESS SECOND LINE ADDRESS P O BOX # CITY STATE FIVE DIGIT ZIP CODE ZIP CODE EXTENSION PROVINCE COUNTRY POSTAL CODE EXPIRATION DATE CERTIFICATION DATE LICENSE RANK LICENSE SPECIALTY EMAILADDRESS 12 16 000261 VANITY N FAULKNER 15 FIREFLY LN HAMPTON VA 23666 0000 02/06/2025 11/08/2024 WTP VCOTT001@GMAIL.COM