black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

SAMUEL J. GROOM

PRODUCER NON-RESIDENT

License Number:
PRN474630
Status:
First Licensure:
01/23/2024
Cancel Date:
None

Mailing:
KILLINGTON, VT 05751
Phone:
+1 (802) 772-3213
Fax:
+1 (888) 497-3093
Email:
samuel.groom@ubs.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 01/23/2024

Agency

Name Issue Date License Number Expiration Date Cancel Date
UBS FINANCIAL SERVICES INSURANCE AGENCY INC
02/06/2024 AGN44426

Employer

Name Issue Date License Number Expiration Date Cancel Date
AMERICAN GENERAL LIFE INSURANCE COMPANY
03/19/2026 LHF119
ATHENE ANNUITY AND LIFE COMPANY
03/04/2026 LHF64369
MINNESOTA LIFE INSURANCE COMPANY
07/26/2024 LHF216

Authority

Description Issue Date Termination Date Status
HEALTH 01/23/2024 Active
LIFE 01/23/2024 Active
VARIABLE CONTRACTS 01/23/2024 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
7021150

Other Addresses

Address Type
UBS FINANCIAL SERVICES
67 MERCHANTS ROW
RUTLAND, VT 05701-5910
Office

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 03/28/2026 07:11:01 AM