Agency Information

DERGALIS ASSOCIATES, LLC

210 LAKE DRIVE EAST

CHERRY HILL, NJ 08002

856-795-7093

alex.dergalis@equitable.com

9599109

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res. Producer Firm	3560312	07/24/2020	Active	07/24/2020	07/31/2026

Qualification Type	Original Issue Date	Status	Effective Date
Health	07/24/2020	Active	07/24/2020
Life	07/24/2020	Active	07/24/2020

Company Name	Appointment Type	Status	Active Date
523
PHILADELPHIA AMERICAN LIFE INSURANCE COMPANY	Health	Active	08/14/2023
	Life	Active	08/14/2023

row(s) 1 - 2 of 2

Name	Association Type	Agent	Begin Date	End Date
ALEXIS DERGALIS	Designated Resp Lic Prdcr	Yes	07/24/2020	-

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