Commission Detail
| Notary ID: | 1044747 |
| Last Name: | Clark |
| First Name: | Cathleen |
| Middle Name: | |
| Birth Date: | 9/19/XX |
| Transaction Type: | REN |
| Certificate: | EE 211037 |
| Status: | EXP |
| Issue Date: | 06/26/12 |
| Expire Date: | 06/25/16 |
| Bonding Agency: | 1st State Insurance |
| Mailing Address: | All Children's Specialty Phy. 601 5th St. S., Ste 306 St. Petersburg, FL 33701-0000 |
[Department
of State][Notary
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Florida
Department of State Division of Corporations
P.O. Box 6327
Tallahassee, FL. 32314
Phone (850) 245-6975