Agency Information

ETQ HK SPV INC

Address:

12750 CITRUS PARK LN STE 110

TAMPA, FL 33625

Phone

727-754-9753

URL:

Email:

legalandcompliance@e-telequote.com

National Producer Number:

17212993

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res. Producer Firm	944226	04/02/2014	Active	04/02/2014	04/30/2026

Qualification Type	Original Issue Date	Status	Effective Date
Health	04/02/2014	Active	04/02/2014
Life	04/02/2014	Active	04/02/2014

Company Name	Appointment Type	Status	Active Date
971
HUMANA INSURANCE COMPANY	Health	Active	07/25/2014
141630
Company Name	Appointment Type	Status	Active Date
HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CORPORATION	Health	Active	10/18/2017

row(s) 1 - 2 of 2

Name	Association Type	Agent	Begin Date	End Date
CRAIG CHARLES UCHYTIL	Designated Resp Lic Prdcr	Yes	03/22/2023	-
ROBERT JOSEPH CHAUNCEY	Designated Resp Lic Prdcr	Yes	11/17/2020	-

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