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 23 000937 TONI CRYSTAL L LAWSON 26 MERRILL WAY NEWNAN GA 30263 0000 12/31/2024 02/14/2024 MATA thaiboxfox@gmail.com 41 23 000928 JOSEPH E RAY 908 SPRUCE ST MARTINSVILLE VA 24112 0000 12/31/2024 02/14/2024 MATA joseph.ray@kw.com 41 23 000931 MICAH P TERRILL 1736 HAVRE DE GRACE DRIVE EDGEWATER MD 21037 0000 12/31/2024 02/14/2024 MATA Hotboxboxing@gmail.com 41 23 000930 JOSHUA C FREEMAN 10947 MISSION RIDGE DR. MANASSAS VA 20109 0000 12/31/2024 02/14/2024 MATA jfreemanmma@gmail.com 41 23 000936 STANISLAV GROSU 21035 SYCOLIN RD ASHBURN VA 20147 0000 12/31/2024 02/14/2024 MATA Stanislav.grosu92@gmai.com 41 23 000943 ISAIAH E MONROE 105 CASPIA CT RAEFORD NC 28376 0000 12/31/2024 02/22/2024 MATA ISAIAH.MONROE85@GMAIL.COM 41 23 000951 DAVID K WILSON III 1209 BROWNING DRIVE WILMINGTON NC 28405 0000 12/31/2024 02/29/2024 MATA davidkwilson205@gmail.com 41 23 000945 JAKE LEMACKS 11420 BONDURANT DRIVE RICHMOND VA 23236 0000 12/31/2024 02/23/2024 MATA 2SAVEITEMPLECOLLECTIVE@GMAIL.COM 41 23 000948 DUSTIN STANLEY 12915 RUTH HILL RD CHURCH ROAD VA 23833 0000 12/31/2024 02/28/2024 MATA D.STANLEY_777@HOTMAIL.COM 41 23 000953 BRANDON PAGUANDAS 9360 TANEY RD MANASSAS VA 20110 0000 12/31/2024 03/01/2024 MATA BPAGUANDAS@GMAIL.COM 41 23 000946 QATAADA A NUBANI 6811 BRISBANE ST SPRINGFIELD VA 22152 0000 12/31/2024 02/23/2024 MATA Qnubani@gmail.com 41 23 000938 ZACHARY CALMUS 43 PERKINS STREET GLOUCESTER MA 01930 0000 12/31/2024 02/14/2024 MATA ZACHBKFC@GMAIL.COM 41 23 000947 GABRIEL GARDNER P.O. BOX 532 HAMILTON NC 27840 0000 12/31/2024 02/23/2024 MATA GRGARDNER0918@GMAIL.COM 41 23 000935 SHAWN D BROOKS 14745 GULLANT LN WALDORF MD 20601 0000 12/31/2024 02/14/2024 MATA SHAWNBROOKS1026@GMAIL.COM 41 23 000919 BOVAR KHANAKOV 5241 MARCONI A E CARMICHAEL CA 95608 0000 12/31/2024 02/14/2024 MATA khanakovbovar@gmail.com 41 23 000920 BRANDON SHAVERS 679 MURRAY ST JENA LA 71342 0000 12/31/2024 02/14/2024 MATA shaversbrandon7@mail.com 41 23 000921 CAMERON VANCAMP 220 N 500 E LEBANON IN 46052 0000 12/31/2024 02/14/2024 MATA Cameronvancamp7@gmail.com 41 23 000922 CARY CAPRIO 9688 NORFOLK AVE. LAUREL MD 20723 0000 12/31/2024 02/14/2024 MATA caryc3services@gmail.com 41 23 000923 CRYSTAL VAN WYK 5222 BAY RD ROCK HILL SC 29732 0000 12/31/2024 02/14/2024 MATA hentieinspire@gmail.com 41 23 000925 DUSTIN GARRETT 1668 UPPER PEACHTREE RD MURPHY NC 28906 0000 12/31/2024 02/14/2024 MATA dgarrettee@gmail.com 41 23 000926 JAMES BROWN 1152 HARBOUR DR APT 204 WILMINGTON NC 28401 0000 12/31/2024 02/14/2024 MATA Dotj200@gmail.com 41 23 000927 JORDAN CHRISTENSEN 8985 APPELLATION AVE LAS VEGAS NV 89148 0000 12/31/2024 02/14/2024 MATA perryjordan07@gMail.com 41 23 000932 MURAT KILIMETOV 301 DR MARTIN LUTHER KING JR AVE N ALBUQUERQUE NM 87103 0000 12/31/2024 02/14/2024 MATA murat77705@icloud.com 41 23 000933 NATHAN RIVERA 5222 BAY RD ROCK HILL SC 29732 0000 12/31/2024 02/14/2024 MATA hentieinspire@gmail.com 41 23 000934 RYAN SHOUGH 308 N MADRIVER ST A # 4 BELLEFONTAINE OH 43311 0000 12/31/2024 02/14/2024 MATA ryanpshough@hotmail.com 41 23 000939 TREY COOK 160 SUNDA CIRCLE #210 WINCHESTER VA 22602 0000 12/31/2024 02/14/2024 MATA trey.fighter.cook11@gmail.com 41 23 000941 MICAH LIVINGSTON 4329 NORFOLK SAINT LOUIS MO 63111 0000 12/31/2024 02/15/2024 MATA MICAHLIVINGSTON693@HOTMAIL.COM 41 23 000942 CRISTINA CRIST 2281 FM 275 NORTH CUMBY TX 75433 0000 12/31/2024 02/15/2024 MATA CRISTINAACRIST@GMAIL.COM 41 23 000944 WILLIAM WOLK 3600 CONSHOHOCKEN AVE APT 115 PHILADELPHIA PA 19131 0000 12/31/2024 02/23/2024 MATA BWOLK10@YAHOO.COM 41 23 000949 ELVIN G ROMERO 2401 SHERBOURNE RD RICHMOND VA 23237 0000 12/31/2024 02/28/2024 MATA ELVIN871@YAHOO.COM 41 23 000950 GUSTAVO R DUARTE 703 JARMAN STREET JACKSONVILLE NC 28540 0000 12/31/2024 02/29/2024 MATA RAWMMA2022@GMAIL.COM 41 23 000952 MARK GUGLIELMINI 5550 WESTCOTT CIRCLE FREDERICK MD 21703 0000 12/31/2024 03/01/2024 MATA MGUGLIELMINI225@GMAIL.COM