DEPARTMENT OF INSURANCE

Name	Insurance Intermediary Group, Inc.	DOIID	595146	NAIC NPN	4629117

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Non Resident	Agent	Life	11/15/2004	3/31/2008
Inactive	Non Resident	Agent	Health	11/15/2004	3/31/2008

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

No License Renewal Information

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date.

Address Information

Type	Address
Business / Home Office	2536 Countryside Blvd #500 Clearwater, FL 33763

Phone Information

Type	Phone
Business / Home Office	(727) 791-0255