Agency Information

WESTERN INSURANCE SPECIALTIES INC

Address:

9740 S MCCARRAN BLVD STE 103

RENO, NV 89523-9204

Phone

775-826-2333

URL:

Email:

cal@wisnv.com

National Producer Number:

4582131

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Res. Third Party Administrator	3804	10/01/2009	Active	10/01/2009	08/31/2024
Resident Producer Firm	3557	10/01/2001	Active	10/01/2001	02/28/2027

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	10/01/2001	Active	10/01/2001
Health	10/01/2001	Active	10/01/2001
Life	10/01/2001	Active	10/01/2001
Property	10/01/2001	Active	10/01/2001
TPA1 -Life/Health Insurance	10/01/2009	Active	10/01/2009
Var. Annuities/Var. Life	10/01/2001	Active	10/01/2001

Company Name	Appointment Type	Status	Active Date
37
AMERICAN FIDELITY ASSURANCE COMPANY	Health	Active	05/01/2004
	Life	Active	05/01/2004
103
Company Name	Appointment Type	Status	Active Date
PRINCIPAL LIFE INSURANCE COMPANY	Health	Active	08/17/1992
	Life	Active	08/17/1992
1550
Company Name	Appointment Type	Status	Active Date
PROMINENCE HEALTHFIRST	Health	Active	10/16/2022
1792
Company Name	Appointment Type	Status	Active Date
PROMINENCE PREFERRED HEALTH INSURANCE COMPANY INC	Health	Active	10/16/2022
556
Company Name	Appointment Type	Status	Active Date
PRUDENTIAL INSURANCE COMPANY OF AMERICA	Health	Active	09/17/2007
	Life	Active	09/17/2007
	Var. Annuities/Var. Life	Active	09/17/2007

row(s) 1 - 9 of 9

Name	Association Type	Agent	Begin Date	End Date
CHERYL A LATHAM	Designated Resp Lic Prdcr	Yes	09/15/2020	-

1 - 1