License Detail

number106469
last_nameAbbott
first_namePaul
middle_nameE.
prefixMr.
suffixJr.
address1113 Graystone Farm Rd.
cityWhite Hall
stateMD
zip21161
expire_date3/31/2016
date_granted6/30/2010
work_phone4104941111
employerKibart, Inc.
branch1MEC
StatusACT

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