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
12	16	000260	ANGGIE L VALDIVIEZO 		13455 SUNRISE VALLEY DR			HERNDON	VA	20171	0000				08/30/2024	07/17/2024	WTP		COOKIEVALDIVIEZO@GMAIL.COM