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 13 12 000151 TIMOTHY A JONES 186 SCOTTS FARM RD LYNCHBURG VA 24504 0000 06/30/2024 07/20/2023 BTTP timothyjones0822@gmail.com