Individual Information

KYLE MITZNER

Address:

TUCSON, AZ 85743-5243

Status:

Active

Email:

kyle.mitzner@geniusavenue.com

Date:

05/14/2021

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	3670612	05/14/2021	Active	05/14/2021	05/31/2024

Qualification Type	Original Issue Date	Status	Effective Date
Health	05/14/2021	Active	05/14/2021
Life	05/14/2021	Active	05/14/2021

Company Name	Appointment Type	Status	Active Date
1142
TIER ONE INSURANCE COMPANY	Health	Active	10/20/2021

row(s) 1 - 1 of 1

Organization	Association Type	Type	Beg dte	End dte
PHC INS AGENCY LLC	Designated Resp Lic Prdcr	Agency	06/17/2021	-

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