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Name:
Derrick Logan Jackson
Certificate Status:
Active
Address:
11148 West 76th Terrace, #20
Shawnee, KS 66214-0000
Permit Status:
Firm/Employer:
Discipline and/or Board Action:
NO
Certificate Issue Date:
10/01/1990
Certificate Number:
6298
Permit Number:
Permit Issue/Renew Date:
/ /
Permit Expiration Date:
/ /