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Details for COLLINS, DOMENIQUE

Agent Details
Name
COLLINS, DOMENIQUE  
Address
1931 N ARBOGAST ST GRIFFITH, IN 46319-1268 
Business Phone
(877) 256-1640 
Internet
 
Email
MADISONLICENSING@HUMANA.COM  
Status
Active 
Issue Date
Nov 08, 2017 
License Status Expires Number
Non-Resident Producer Active Sep 30, 2022 641730
      Accident and Hlth or Sickness Active Issued: Aug 09, 2018
      Life Active Issued: Nov 08, 2017
      Accident & Health Inactive Issued: Nov 08, 2017
Agency Affiliations City State License Number Active Date Status
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