| Type | Issue Date | Qualifying Appointment |
|---|---|---|
| AGENCY LICENSE (2105) | 6/17/2009 | Appointment not required for this license type. |
| Company Name | Issue Date | Exp Date |
|---|---|---|
| MINNESOTA LIFE INSURANCE COMPANY | 7/11/2023 | 7/31/2027 |
| Street Address | City | State | Zip | County | Location Agent In Charge |
|---|---|---|---|---|---|
| 510 COUNTY ROAD 466 | LADY LAKE | Florida | 32159 |