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Details for PHONTHIPSAVATH, CHINTANA

Agent Details
Name
PHONTHIPSAVATH, CHINTANA  
Address
4902 W WATERS AVE SUITE 100 TAMPA, FL 33634 
Business Phone
(813) 574-5600 
Internet
 
Email
lisa@srhealthcaredirect.com  
Status
Inactive  - Lapsed
Issue Date
Aug 31, 2021 
License Status Expires Number
Non-Resident Producer Inactive Aug 31, 2021 435769
      Accident & Health Inactive Issued: Jan 16, 2013
      Accident and Hlth or Sickness Inactive Issued: Aug 09, 2018
      Life Inactive Issued: Jan 16, 2013
Agency Affiliations City State License Number Active Date Status
No records found.
Company Affiliations City State Type Active Date
No records found.