DEPARTMENT OF INSURANCE

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 : Long Term Care Insurance Primer
DOI ID	Name	Completion Date	Compliance Date
610648	Gavarrete, Christina Marie	08/17/2021	08/31/2021