| No | Nama Lengkap | Cabang Olahraga | Asal Provinsi | No. LANKOR |
| 1 | TENGKU MUHAMMAD IKHSAN RAHARDI | FUTSAL | SUMUT | 242008947 |
| 2 | IBRAHIM SYAH HM SIMBOLON, M.Si | TAEKWONDO | SUMUT | 242008948 |
| 3 | SYAFRIL GUNAWAN, S.Pd | RENANG | SUMUT | 242008949 |
| 4 | DIAN SUSILO, S.Pd | PENTAQUE | SUMUT | 242008950 |
| 5 | DAVID HASIOLAN PURBA | KARATE | SUMUT | 242008951 |
| 6 | JULIAN PRANAMA SYAHPUTRA | RENANG | SUMUT | 242008952 |
| 7 | SUHENDRA | ANGKAT BERAT | SUMUT | 242008953 |
| 8 | CHAIRUL SYOFYAN | SEPAK BOLA | SUMUT | 242008954 |
| 9 | RAJA IMAM MUDA HARAHAP | PANJAT TEBING | SUMUT | 242008955 |
| 10 | IMAM TYSON TOGATOROP | SENAM DANCE | SUMUT | 242008956 |
| 11 | SAMUEL JAN RAYA HUTASOIT | KARATE | SUMUT | 242008957 |
| 12 | SRI WIGIATI | KARATE | SUMUT | 242008958 |
| 13 | ADJIE BINTANG PAMUNGKAS | KABADI | SUMUT | 242008959 |
| 14 | MUHAMMAD HERIADI | TARUNG DERAJAT | SUMUT | 242008960 |
| 15 | MUHAMMAD SYAWALUDDIN | ATLETIK | SUMUT | 242008961 |
| 16 | MHD . HENDRIA, S.Pd | CRIKET | SUMUT | 242008962 |
| 17 | CHINTYA KUMALA, S.Pd | RENANG | SUMUT | 242008963 |
| 18 | Eman Rahayu Pratama | PANAHAN | SUMUT | 242008964 |
| 19 | IRWAN, SH.C.Med | PENCAK SILAT | SUMUT | 242008965 |
| 20 | AULIYA RAHMAN SITORUS | ARUNG JERAM | SUMUT | 242008966 |
| 21 | ARIANTO | PENCAK SILAT | SUMUT | 242008967 |
| 22 | MUHAMMAD IRFAN, S.T | DRUMBAND | SUMUT | 242008968 |
| 23 | MUHAMMAD NUR IKHSAN | ATLETIK | SUMUT | 242008969 |
| 24 | Muhammad Afriza | FITNES & BINARAGA | SUMUT | 242008970 |
| 25 | FAISAL RIZA, SE | VOLI | SUMUT | 242008971 |
| 26 | RIDUAN MALIK, S.PdI | DRUMBAND | SUMUT | 242008972 |
| 27 | TANDIONO | BASKET | SUMUT | 242008973 |
| 28 | MUHAMMAD ADLANSYAH | GATEBALL | SUMUT | 242008974 |
| 29 | INDRA BASTIAN SAMOSIR, S.Pd | JUDO | SUMUT | 242008975 |
| 30 | LEONARDO GUSTIAN SIANTURI, S.Pd | RENANG | SUMUT | 242008976 |
| 31 | BAGAS FIRMANSYAH | TAKRAW | SUMUT | 242008977 |
| 32 | HATIZAH | VOLI | SUMUT | 242008978 |
| 33 | DELLA SRI TRINITA SINAGA | JUDO | SUMUT | 242008979 |
| 34 | HARRY AGUSTIAN | TAKRAW | SUMUT | 242008980 |
| 35 | DIKI DERMAWAN SARAGIH | SEPAK BOLA | SUMUT | 242008981 |
| 36 | RIDUAN AMIN ISMAIL, S.Pd | TAEKWONDO | SUMUT | 242008982 |
| 37 | M . SUJONO TAMBUNAN, S.Pd | PENTAQUE | SUMUT | 242008983 |
| 38 | MUHAMMAD AJI AKBAR | PENTAQUE | SUMUT | 242008984 |
| 39 | JONNY LIE | GATEBALL | SUMUT | 242008985 |
| 40 | ALI MUKHTAR HARAHAP, S.Pd, M.Or | TARUNG DERAJAT | SUMUT | 242008986 |
| 41 | FAHRIZAL PERANGIN ANGIN | ARUNG JERAM | SUMUT | 242008987 |
| 42 | MUHAMMAD ALI SYAHPUTRA | PENCAK SILAT | SUMUT | 242008988 |
| 43 | RITA LASROHAYATI SIHOMBING | CATUR | SUMUT | 242008989 |
| 44 | YUDHI FADILLAH | SEPAK BOLA | SUMUT | 242008990 |
| 45 | Nurul Pauzi | SEPEDA | SUMUT | 242008991 |
| 46 | ALI SAHBANA HASIBUAN | TARUNG DERAJAT | SUMUT | 242008992 |
| 47 | JUL PERMAN BARUS | FUTSAL | SUMUT | 242008993 |
| 48 | SUHENDRI | SEPAK BOLA | SUMUT | 242008994 |
| 49 | MUHAMMAD NASRIL FAHMI | VOLI | SUMUT | 242008995 |
| 50 | SISWONO | ATLETIK | SUMUT | 242008996 |
