MICHAEL EUGENE CLARK

Address:

SCOTTSDALE, AZ 85255

Status:

Active

Email:

mclark@sgiamedicare.com

Date:

10/30/2008

ButtomHolder

License Information

License TypeLicense NumberOriginal Issue DateStatusEffective Date Expiration Date
Non-Res Producer/Producer Firm62358210/30/2008Active10/30/200810/31/2026

Qual Information

Qualification TypeOriginal Issue DateStatusEffective Date
Health10/30/2008Active10/30/2008
Life10/30/2008Active10/30/2008