Individual Information

DALE A NICHOLAS

TREMONTON, UT 84337

Active

dale@nicholasgroup.net

05/02/1988

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	24072	10/01/2001	Active	10/01/2001	03/31/2027

Qualification Type	Original Issue Date	Status	Effective Date
Health	10/01/2001	Active	10/01/2001
Life	10/01/2001	Active	10/01/2001
Health	05/02/1988	Inactive	10/01/2001
Life	05/02/1988	Inactive	10/01/2001

Company Name	Appointment Type	Status	Active Date
106276
AETNA HEALTH INC (PA)	Health	Active	07/01/2009
770
Company Name	Appointment Type	Status	Active Date
AETNA HEALTH INSURANCE COMPANY	Health	Active	03/29/2008
7
Company Name	Appointment Type	Status	Active Date
AETNA LIFE INSURANCE COMPANY	Health	Active	03/29/2008
	Life	Active	03/29/2008
63
Company Name	Appointment Type	Status	Active Date
AMERICAN NATIONAL INSURANCE COMPANY	Life	Active	06/20/2008
505
Company Name	Appointment Type	Status	Active Date
CIGNA HEALTH AND LIFE INSURANCE COMPANY	Health	Active	04/11/2011
	Life	Active	04/11/2011
1538
Company Name	Appointment Type	Status	Active Date
HMO COLORADO INC D/B/A HMO NEVADA	Health	Active	05/01/2017
442
Company Name	Appointment Type	Status	Active Date
NATIONAL GUARDIAN LIFE INSURANCE COMPANY	Health	Active	05/03/2017
940
Company Name	Appointment Type	Status	Active Date
NATIONAL HEALTH INSURANCE COMPANY	Health	Active	09/29/2022
	Life	Active	09/29/2022
1620
Company Name	Appointment Type	Status	Active Date
ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE INC	Health	Active	05/01/2017
146052
Company Name	Appointment Type	Status	Active Date
SELECTHEALTH INC	Health	Active	03/23/2021
1398
Company Name	Appointment Type	Status	Active Date
TRUSTMARK LIFE INSURANCE COMPANY	Health	Active	08/28/2023
	Life	Active	08/28/2023

row(s) 1 - 15 of 15

Organization	Association Type	Type	Beg dte	End dte
NATIONAL INSURANCE REVIEW OF NEVADA INC	Designated Resp Lic Prdcr	Agency	09/15/2020	-

1 - 1