| Operator Class | Amateur Extra |
| Group Code | D Group |
| Region Code | 6 |
| Previous Call Sign | N |
| Previous Operator Class | General |
| License ID | 0009861456 |
| Street Address | 🔒 [PRIVATE] |
| City / State / ZIP | 🔒 [PRIVATE] |
| Applicant Type | Individual |
| License Status | Cancelled |
| Grant Date | 12/29/2020 |
| Expiration Date | 12/29/2030 |
| Effective Date | 01/10/2022 |