Field Name · Applicant
Italic names are derived; accent values differ from the applicant’s prior license.
| Applicant Type | B - Amateur Club |
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| Entity Type | L - Licensee or Assignee |
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| Entity Name | TN Dept Of Health Medical Reserve Corps |
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| Attention | CHAD R BRUCKMAN |
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| First Name / Middle Init / Last Name / Name Suffix | |
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| Street Address | 185 Treasure Ln |
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| Po Box | |
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| Locality | Johnson City |
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| County | Washington County |
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| State | TN - Tennessee |
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| Postal Code | 37604 |
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| Zip Location | 36°17'58.5"N 82°22'59.4"W |
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| Maidenhead | EM86th |
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| FRN | 0027695907 |
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| Geo Region | 4 / TN |
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| Licensee ID/SGIN | L02200543 / 000 |
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| Callsign | KN4NUW |
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| Last Action Date | 2018-08-03 |
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| Radio Service | HA - Amateur |
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| App Purpose | MD - Modification |
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| App Source | I - Online |
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| App Status | G - Granted |
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| Entered Timestamp | 2018-07-14 |
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| Fee Control Num | |
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| Orig Purpose | MD - Modification |
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| Receipt Date | Mon 2018-07-16 |
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| Payment Date | |
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| Is From Vec | |
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| Is Trustee | |
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| Operator Group | C - 1x3 |
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| Licensee Class | trustee: E - Amateur Extra |
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| New Seq Callsign | N |
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| Trustee Callsign | KM4JNR |
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| Trustee Name | BRUCKMAN, CHAD R |
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| ULS Group / ULS Region | C / 4 |
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| Prev Callsign / Prev Class | |
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| Vanity Relationship | |
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| Vanity Type | F - By List (Club) |
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| Fee Exempt / Waiver | N / N |
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