| Type | Issue Date | Qualifying Appointment |
|---|---|---|
| AGENCY LICENSE (2105) | 8/18/2009 | Appointment not required for this license type. |
| Type | Issue Date | Status |
|---|---|---|
| AGENCY LICENSE (2105) | 4/27/2006 | INVALID |
| Street Address | City | State | Zip | County | Location Agent In Charge |
|---|---|---|---|---|---|
| 1720 HARRISON STREET SUITE 6-A | HOLLYWOOD | Florida | 33020 | KIM BEN-SHALOM (D064864) |