California
Contra Costa
Lafayette
General Lines Agent
active
1306877
Old TDI license number: 11765087
New TDI license number: 1306877
License type: GL
License qualifications: LAH
Report date: 06/05/2013
License issue date: 01/25/2005
No affiliations
No associations
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Profile ID: FRUS-INS-P-126597