Course Attendance Information
PR01793: 5th Gear Enterprises, LLC
Experior Provider Number: S15320 
Provider Type: Independent
Certification Date: 6/12/2018

Address: 22802 SW Forrest Creek Drive
Suite 102
Sherwood, OR 97140
Contact: Deborah Deragon
Telephone: 503-523-2339
Status: Active
Termination Date: N/A
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Course Attendees
Course Name :  Concepts and History of Insurance
DOI IDNameCompletion Date Compliance Date
923778 Jackson, Buddy 05/18/2021 06/30/2021
854532 Crenshaw, Joseph Nathaniel 06/11/2020 03/31/2022
522875 Straub, Garrick A 04/30/2020 06/30/2021

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