Details as stated in the register
- DPOR board / occupation / certificate number
- 2705064713
- Source license rank
- A
- Source specialty codes
- RBC CBC
- Source certification date
- 12/19/2001
- Source expiration date
- 12/31/2027
- Address city as filed
- EIGHTY FOUR
- Address state as filed
- PA
- Address ZIP as filed
- 15330
Register status and classifications are reproduced from the source. No independently verified business activity, customer premises, contact details, insurance or trade license is implied.