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Details for FOUNTAIN, DWAYNE ANTHONY

Agent Details
Name
FOUNTAIN, DWAYNE ANTHONY 
Address
3240 LAS VEGAS BLVD N APT 321 LAS VEGAS, NV 89115-1546 
Business Phone
(702) 665-1147 
Internet
 
Email
DEWAYNE.FOUNTAIN@MEDICARE10.COM  
Status
Active 
Issue Date
Sep 28, 2018 
License Status Expires Number
Non-Resident Producer Active Jun 30, 2023 691031
      Accident and Hlth or Sickness Active Issued: Sep 28, 2018
Agency Affiliations City State License Number Active Date Status
EHEALTH INSURANCE SERVICES, INC. GOLD RIVER CA 91882 Sep 08, 2020 Active
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