DEPARTMENT OF INSURANCE

Name	Sam, Peter	DOIID	1032167	NAIC NPN	18565935

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Active	Non Resident	Agent	Health	8/20/2024		10/31/2025
Active	Non Resident	Agent	Personal Lines	3/11/2019		10/31/2025

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

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	08/15/2025	10/31/2025

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date. Licensees subject to CE must complete CE requirements before Next Compliance Date in order to successfully complete the License Renewal Process.

Address Information

Type	Address
Business / Home Office	4250 Ivy Run Cir Duluth, GA 300965367
Residence	Not Public Information

Internet Information

Type	Address
Business Email	teletechlicensing@teletech.com

Phone Information

Type	Phone
Business / Home Office	(678) 779-8347