Agency Information

CLIENTS CHOICE INSURANCE, LLC

17470 N PACESETTER WAY

SCOTTSDALE, AZ 85255

623-444-2454

service@myagentccis.com

20397799

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res. Producer Firm	3867205	01/17/2023	Active	01/17/2023	01/31/2026

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	01/17/2023	Active	01/17/2023
Health	01/17/2023	Active	01/17/2023
Life	01/17/2023	Active	01/17/2023
Personal Lines	01/17/2023	Active	01/17/2023
Property	01/17/2023	Active	01/17/2023

Company Name	Appointment Type	Status	Active Date
1460
ALPHA DENTAL OF NEVADA INC	Health	Active	02/06/2023
203
Company Name	Appointment Type	Status	Active Date
DELTA DENTAL INSURANCE COMPANY	Health	Active	02/06/2023
793
Company Name	Appointment Type	Status	Active Date
FIDELITY SECURITY LIFE INSURANCE COMPANY	Health	Active	02/16/2023
1409
Company Name	Appointment Type	Status	Active Date
MIDVALE INDEMNITY COMPANY	Casualty	Active	02/16/2023
	Personal Lines	Active	02/16/2023
	Property	Active	02/16/2023
14146
Company Name	Appointment Type	Status	Active Date
NGM INSURANCE COMPANY	Casualty	Active	02/16/2023
	Personal Lines	Active	02/16/2023
	Property	Active	02/16/2023
146052
Company Name	Appointment Type	Status	Active Date
SELECTHEALTH INC	Health	Active	01/26/2023
18167
Company Name	Appointment Type	Status	Active Date
SILVERSUMMIT HEALTHPLAN INC	Health	Active	01/19/2023
608
Company Name	Appointment Type	Status	Active Date
STANDARD FIRE INSURANCE COMPANY (THE)	Casualty	Active	01/18/2023
	Property	Active	01/18/2023
16894
Company Name	Appointment Type	Status	Active Date
WELLCARE PRESCRIPTION INSURANCE INC	Health	Active	01/19/2023

row(s) 1 - 14 of 14

Name	Association Type	Agent	Begin Date	End Date
ANTOINETTE LYNN CHAVEZ	Designated Resp Lic Prdcr	Yes	01/17/2023	-

1 - 1