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Details for DERRICK, SAMUEL SHANE

Agent Details
Name
DERRICK, SAMUEL SHANE 
Address
1553 E 11245 S SANDY, UT 84092 
Business Phone
(801) 706-4489 
Internet
 
Email
derrickinsurance@gmail.com  
Status
Active 
Issue Date
Dec 04, 2013 
License Status Expires Number
Resident Producer Active Nov 30, 2023 318530
      Accident and Hlth or Sickness Active Issued: Aug 09, 2018
      Casualty Active Issued: Mar 31, 2014
      Life Active Issued: Jun 08, 2009
      Property Active Issued: Mar 31, 2014
      Variable Life/Variable Annuity Active Issued: Sep 16, 2021
      Accident & Health Inactive Issued: Jun 08, 2009
Agency Affiliations City State License Number Active Date Status
NYLIFE SECURITIES LLC NEW YORK NY 256993 Sep 29, 2021 Active
STONE HILL NATIONAL SLC UT 4915 Dec 04, 2013 Active
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