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Details for LAKE, GREGORY LEE

Agent Details
Name
LAKE, GREGORY LEE 
Address
4201 S RAINTREE DR NAMPA, ID 83686-6487 
Business Phone
(208) 989-5262 
Internet
 
Email
glake@ideclareindependence.us  
Status
Active 
Issue Date
Jun 12, 2012 
License Status Expires Number
Non-Resident Producer Active Nov 30, 2021 415062
      Accident and Hlth or Sickness Active Issued: Aug 09, 2018
      Life Active Issued: Jun 12, 2012
      Accident & Health Inactive Issued: Jun 12, 2012
Resident Producer Inactive Nov 30, 2013 139516
      Accident & Health Inactive Issued: May 16, 2002
      Life Inactive Issued: May 16, 2002
Resident Agent/Agency Inactive Sep 30, 2003 139516
      Accident & Health Inactive Issued: Sep 12, 2001
      Life Inactive Issued: Sep 12, 2001
Non-Resident Agent/Agency Inactive Jul 31, 2002 128532
      Accident & Health Inactive Issued: Aug 01, 2000
      Life Inactive Issued: Jul 17, 2000
Agency Affiliations City State License Number Active Date Status
INDEPENDENCE INSURANCE GROUP LLC NAMPA ID 835483 Mar 15, 2021 Active
STONE HILL NATIONAL SLC UT 4915 Sep 15, 2011 Active
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