Agency Information

ASSURED MANAGEMENT INSURANCE SERVICES, INC.

Address:

998 FOURTH GREEN DRIVE

INCLINE VILLAGE, NV 89451

Phone

775-232-9863

URL:

Email:

danh@amiscal.com

National Producer Number:

1680312

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Resident Producer Firm	7075	10/01/2001	Active	01/21/2020	01/31/2026

Qualification Type	Original Issue Date	Status	Effective Date
Health	10/01/2001	Active	01/21/2020
Life	10/01/2001	Active	01/21/2020

Company Name	Appointment Type	Status	Active Date
1379
HOMETOWN HEALTH PLAN INCORPORATED	Health	Active	07/02/2020
995
Company Name	Appointment Type	Status	Active Date
HOMETOWN HEALTH PROVIDERS INSURANCE COMPANY	Health	Active	07/02/2020

row(s) 1 - 2 of 2

Name	Association Type	Agent	Begin Date	End Date
DANIEL B HOLETS	Designated Resp Lic Prdcr	Yes	07/09/2021	-

1 - 1