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 41 03 002621 JAMES DILLARD VAUGHN SR 5143 LITTLE DAM RIVER RD CLAUDVILLE VA 24076 0000 12/31/2024 01/04/2024 MNGR