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 000844 LIAM PANERO 6634 EAMES WAY BETHESDA MD 20817 0000 12/31/2025 12/11/2024 MATA liampanero@gmail.com 41 23 000977 BRANDON A MORAN 4607 MEADOW AVENUE SAVANNAH GA 31405 0000 12/31/2025 12/06/2024 MATA BRAMOR25@GMAIL.COM 41 23 000974 THOMAS LANE 115 MISTY MEADOW DR GREENVILLE SC 29615 0000 12/31/2025 12/04/2024 MATA TLANE645@GMAIL.COM 41 23 000975 JEREMY J HENRY 6365 LINSDALE ST DETROIT MI 48204 0000 12/31/2025 12/06/2024 MATA BADCOMBONATION1@GMAIL.COM 41 23 000976 STEPHEN A GORDY 2111 BISHOP HILL RD. CHILLICOTHE OH 45601 0000 12/31/2025 12/06/2024 MATA ALEXGORDYMMA@GMAIL.COM 41 23 000978 TYSHAWN WILLIAMS 3801 BARRINGTON BRANCH CT HENRICO VA 23233 0000 12/31/2025 12/06/2024 MATA BABYSAVAGETW@GMAIL.COM 41 23 000979 JOEL GALARZA LOPEZ 5835 MAST DR. RICHMOND VA 23224 0000 12/31/2025 12/06/2024 MATA EVANISDAD2018@GMAIL.COM 41 23 000980 MARKEVIAN WILLIAMS 127 FALLIN BLVD. GOLDSBORO NC 27534 0000 12/31/2025 12/06/2024 MATA MARKEVIANWILLIAMS21@GMAIL.COM 41 23 000981 ROLAND J DUNLAP 1424 NE MIAMI PL MIAMI FL 33132 0000 12/31/2025 12/11/2024 MATA ROLLYDUNLAP@GMAIL.COM 41 23 000982 ALEX CUNAHAY 2018 STONEQUARTER RD HENRICO VA 23238 0000 12/31/2025 12/06/2024 MATA AFCUNUHAY@GMAIL.COM 41 23 000983 JOE HAM 3054 CAUSEY RD AUSTELL GA 30106 0000 12/31/2025 12/06/2024 MATA jhjoehamm@gmail.com 41 23 000984 WILLIAM KIRK 14305 GAINES AVE ROCKVILLE MD 20853 0000 12/31/2025 12/11/2024 MATA BILLY.KIRK4747@GMAIL.COM 41 23 000985 LUCAS MARTINO 8702 OLD DOMINION DR. MCLEAN VA 22102 0000 12/31/2025 12/13/2024 MATA luke1707@gmail.com 41 23 000986 MATTHEW G CRAWFORD 10177 IRONGATE WAY MANASSAS VA 20109 0000 12/31/2025 12/13/2024 MATA TheBigSmileMMA@gmail.com 41 23 000987 DALE L REED JR 802 SPRUE AVE. MILFORD DE 19963 0000 12/31/2025 12/18/2024 MATA DJrReed@icloud.com 41 23 000988 ALPHA O STROUD 615 FOREST LN. WALLACE NC 28466 0000 12/31/2025 12/18/2024 MATA alphaomegaman4@gmail.com