black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

GREG GRAHAM STULTZ

PRODUCER NON-RESIDENT

License Number:
PRN275919
Status:
First Licensure:
09/27/2016
Cancel Date:
None

Mailing:
PEORIA, AZ 85383
Phone:
+1 (602) 738-8413
Fax:
+1 (623) 815-5854
Email:
gstultz279@live.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 09/27/2016

Agency

Name Issue Date License Number Expiration Date Cancel Date
ICM INS SERVICES LLC
11/17/2016 AGN278802 10/19/2021

Employer

Name Issue Date License Number Expiration Date Cancel Date
AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS
07/21/2017 LHF645 04/01/2018
AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS
04/01/2018 LHF306110 05/11/2021
INDEPENDENCE AMERICAN INSURANCE COMPANY
11/10/2023 PCF86149
UNITED STATES FIRE INSURANCE COMPANY
10/28/2020 PCF101256

Authority

Description Issue Date Termination Date Status
CASUALTY 08/22/2017 Active
HEALTH 09/27/2016 Active
LIFE 09/27/2016 Active
PROPERTY 08/22/2017 Active
SURPLUS LINES 07/17/2020 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
18097468

Other Addresses

Address Type
PEORIA, AZ 85383
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: 05/18/2025 01:59:11 AM