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Lynn Marie Goya
CLARK COUNTY CLERK
 

Document Details





Instrument Number
201809122044667

Record Date
9/12/2018

Book Type
NOT - NOTARIES

Book/Page

Instrument #
201809122044667

Number of Pages
4

Doc Type
OFF - MINISTER/OFFICIANT

Officiant Name
WORSHAM, STEVEN D

Type
Religious Official - Single Ceremony

Processed By
DOZALB

Status
EXPIRED

Background Check Req?
False

Officiant Residence Address 1
3235 W 96 ST

Officiant Residence City
EVERGREEN PARK

Officiant Residence State
ILLINOIS

Officiant Residence Zip
60805

Officiant Mailing Address 1
3235 W 96 ST

Officiant Mailing City
EVERGREEN PARK

Officiant Mailing State
ILLINOIS

Officiant Mailing Zip
60805

Officiant Phone 1
(708) 248-4522

Officiant Email Address
S.WORSHAM.BETHEL@GMAIL.COM

Officiant Licensure Date
10/1/2008

Ceremony Date
10/27/2018

Party 1 Name
FLETCHER, BROCK

Party 2 Name
FREITAS, MERISSA

Approved Date
9/12/2018

Certificate Expiration Date
10/28/2018