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 05 006282 BISHOP I WALKER 103 SEVEN PINES DRIVE LOCUST GROVE VA 22508 0000 12/31/2025 03/14/2025 WRSL WALKERBISHOP79@YAHOO.COM, 41 05 006278 CHRISTOPHER S SIGMON 146 OLD TAVERN CIRCLE APT. 203 LYNCHBURG VA 24501 0000 12/31/2025 03/14/2025 WRSL SCOTT_SIGMON@YAHOO.COM 41 05 006252 TAUREAN J EDWARDS 219 E. BROAD ST #409 RICHMOND VA 23219 0000 12/31/2025 11/22/2024 WRSL DOITFITNESSLLC@GMAIL.COM 41 05 006270 MACK ALLISON JR 4517 SIPPLE AVENUE BALTIMORE MD 21206 0000 12/31/2025 03/06/2025 WRSL mallison5020@gmail.com 41 05 006272 RODGER WOMACK 3579 JUNEWAY BALTIMORE MD 21213 0000 12/31/2025 03/06/2025 WRSL rodger64womack@gmail.com 41 05 006257 ALBERT W BENJAMIN 4211 OGLETHORPE ST APT 101 HYATTSVILLE MD 20781 0000 12/31/2025 12/06/2024 WRSL 41 05 006283 BRIAN M THOMAS 15474 MOUNTAIN TRACK RD ORANGE VA 22960 0000 12/31/2025 03/14/2025 WRSL Gr8inva@aol.com 41 05 005935 ANDREW D KIM 4830 GARDEN VIEW LANE CHANTILLY VA 20151 0000 12/31/2025 12/11/2024 WRSL V.DREWKIM@GMAIL.COM 41 05 006264 ROY L THACKER III PO BOX 874 NORTON VA 24273 0000 12/31/2025 02/21/2025 WRSL roythacker71@gmail.com 41 05 006289 DALLAS L BREWER 225 BOOKERDALE RD WAYNESBORO VA 22980 0000 12/31/2025 03/14/2025 WRSL GOTTARDIBOXING@GMAIL.COM 41 05 006276 MARCUS D LUCK 606 HOLBROOK ST DANVILLE VA 24541 0000 12/31/2025 03/12/2025 WRSL LUCKSBOXING@GMAIL.COM 41 05 006287 OWEN H HYLTON 1012 FEDERAL ST. LYNCHBURG VA 24502 0000 12/31/2025 03/14/2025 WRSL cannonhylton@gmail.com 41 05 006266 JERRY ROYSTER 1742 GROSS AVENUE RICHMOND VA 23224 0000 12/31/2025 03/05/2025 WRSL ROYSTERBOXING@GMAIL.COM 41 05 006265 MICHAEL J WILLIAMS 5804 W. NORFOLK RD PORTSMOUTH VA 23703 0000 12/31/2025 02/26/2025 WRSL CMBMIKE@GMAIL.COM 41 05 006279 AUSTIN DEANDA 110 AARONS PL. UNIT 103 LYNCHBURG VA 24502 0000 12/31/2025 03/14/2025 WRSL austindeanda03@gmail.com 41 05 006268 ROBERT K WILSON 3144 VICTORY BLVD PORTSMOUTH VA 23702 0000 12/31/2025 03/06/2025 WRSL infougmma@gmail.com 41 05 006285 DERRICK J PORTER 1126 FRUIT PLAIN RD CALLAO VA 22435 0000 12/31/2025 03/14/2025 WRSL DJPTHUNDERCAT@GMAIL.COM 41 05 006284 TYLAR A KEITH 339 SOUTH 3RD STREET COSHOCTON OH 43812 0000 12/31/2025 03/14/2025 WRSL TYLARKEITH@YAHOO.COM 41 05 006263 JOSEPH F LIM 4532 TANEY AVE APT 203 ALEXANDRIA VA 22304 0000 12/31/2025 01/16/2025 WRSL filipinojoe2076@outlook.com 41 05 006280 KEITH JORDAN 296 FOX HOLLOW RD. MOORESVILLE NC 28117 0000 12/31/2025 03/14/2025 WRSL talltwin88@gmail.com 41 05 006253 JAMES A VALENTINE 221 MEDLOCK LANE ALEXANDRIA VA 22304 0000 12/31/2025 12/11/2024 WRSL MERRYPRANKSTER11@GMAIL.COM 41 05 006254 RUBEN R RIVAS 213 BUNNING DRIVE GOLDSBORO NC 27530 0000 12/31/2025 12/11/2024 WRSL BONSAIJIUJITSUACADEMY@GMAIL.COM 41 05 006255 MARK BENAVIDES 211 BUNNING DRIVE GOLDSBORO NC 27530 0000 12/31/2025 12/11/2024 WRSL 41 05 006256 GUNNOR WILLINGHAM 1400 STATESBORO PLACE CIR. STATESBORO GA 30458 0000 12/31/2025 12/06/2024 WRSL gunnarw13a@gmail.com 41 05 006258 ANDRE MONROE 12127 OPEN VIEW LN. LARGO MD 20774 0000 12/31/2025 12/18/2024 WRSL amonroe9314@gmail.com 41 05 006259 SEVEREN M GODWIN 201A FRANKLIN ST. HARRINGTON DE 19952 0000 12/31/2025 12/18/2024 WRSL michaelgodwin619@yahoo.com 41 05 006260 LOUIS J AMABIL 15055 PEPERBOX RD. DELMAR DE 19940 0000 12/31/2025 12/18/2024 WRSL lamabili3@gmail.com 41 05 006261 GREGG WHITE 4534 RABBIT RUN RD. BRIDGEVILLE DE 19933 0000 12/31/2025 12/18/2024 WRSL greggwhite86@gmail.com 41 05 006262 KONNER W KRAESZIG 4000 WILSON BLVD. ARLINGTON VA 22203 0000 12/31/2025 12/18/2024 WRSL kwkraeszig@gmail.com 41 05 006267 JERRY L ROYSTER 5JR 1742 GROSS AVE RICHMOND VA 23224 0000 12/31/2025 03/05/2025 WRSL jerryroyster2020@yahoo.com 41 05 006269 JUAN PABLO GUILLEN VEGA 4707 COMMONS DR. ANNANDALE VA 22003 0000 12/31/2025 03/06/2025 WRSL juapaguillen@gmail.com 41 05 006271 SHARON KISWANI 22453 VERDE GATE TER. BRAMBLETON VA 20148 0000 12/31/2025 03/06/2025 WRSL sheenijohnson@yahoo.com 41 05 006273 ARIYAH I SUMNER 136 CORINTH DR. NEW BERN NC 28562 0000 12/31/2025 03/06/2025 WRSL 4selffitnesshealth@gmail.com 41 05 006274 CHELSEA P SMITH 134 TURKEY QUARTER CREEK RD. COVE CITY NC 28523 0000 12/31/2025 03/06/2025 WRSL princess.cps22@gmail.com 41 05 006275 CLAUDE A BROWN 107 DELANIE WAY NEW BERN NC 28562 0000 12/31/2025 03/06/2025 WRSL cc70west@gmail.com 41 05 006277 MARSHALL MARTIN 472 DEARBORN RD. EVINGTON VA 24550 0000 12/31/2025 03/14/2025 WRSL cutmanmacho@gmail.com 41 05 006281 HEATH G NEAL 1038 FOREST RIDGE DRIVE NEWBERRY SC 29108 0000 12/31/2025 03/19/2025 WRSL 41 05 006286 BRITTANY GILBERT 843 MIDNIGHT DR. CHILHOWIE VA 24319 0000 12/31/2025 03/14/2025 WRSL brittanyleigh2324@gmail.com 41 05 006288 LARRY L BREWER 225 BOOKERDALE RD. WAYNESBORO VA 22980 0000 12/31/2025 03/14/2025 WRSL lavleyle@gmail.com