Individual Information

CHARLIE ZECHARIAH DEAVER

Address:

WESTLAKE VILLAGE, CA 91361-2352

Status:

Active

Email:

executives@greyhawkinsurance.com

Date:

04/21/2022

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	3788898	04/21/2022	Active	04/21/2022	04/30/2028

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	10/30/2024	Active	10/30/2024
Health	04/21/2022	Active	04/21/2022
Life	04/21/2022	Active	04/21/2022
Property	10/30/2024	Active	10/30/2024

Company Name	Appointment Type	Status	Active Date
1538
HMO COLORADO INC D/B/A HMO NEVADA	Health	Active	07/08/2022
1620
Company Name	Appointment Type	Status	Active Date
ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE INC	Health	Active	07/08/2022

row(s) 1 - 2 of 2

Organization	Association Type	Type	Beg dte	End dte
GREYHAWK BROKERS LLC	Designated Resp Lic Prdcr	Agency	05/02/2022	-

1 - 1