| Type | Issue Date | Qualifying Appointment |
|---|---|---|
| AGENCY LICENSE (2105) | 2/21/2019 | Appointment not required for this license type. |
| Street Address | City | State | Zip | County | Location Agent In Charge |
|---|---|---|---|---|---|
| 124 S FLORIDA AVE SUITE 302 | LAKELAND | Florida | 33801 | CAMERON MAGNUSON (P224347) |