black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

CRYSTAL CLEAR INSURANCE LLC,

NON-RESIDENT PRODUCER AGENCY

License Number:
AGN435316
Status:
First Licensure:
10/26/2022
Cancel Date:
None
Renewal Date:
04/01/2027

Street Location:
5012 N FALKENBURG RD
TAMPA, FL 33610-5922
Mailing:
5012 N FALKENBURG RD
TAMPA, FL 33610-5922
Phone:
+1 (813) 246-9596
Email:
admin@crystalclearins.com

History

License Type Start Date End Date
NON-RESIDENT PRODUCER AGENCY 10/26/2022 04/01/2027

Employer

Name Issue Date License Number Expiration Date Cancel Date
EMPLOYERS ASSURANCE COMPANY
01/24/2025 PCF285638
EMPLOYERS COMPENSATION INSURANCE COMPANY
01/24/2025 PCF285639
EMPLOYERS PREFERRED INSURANCE COMPANY
01/24/2025 PCF285637
NATIONAL SPECIALTY INSURANCE COMPANY
06/22/2023 PCF94585
STATE NATIONAL INSURANCE COMPANY INC.
06/22/2023 PCF75933

Affiliated Agent

Name Issue Date License Number Expiration Date Cancel Date
CRYSTAL LEE LEE CROTEAU
10/26/2022 PRN434972

Branch Office

None.

Supervised Entity

None.

Responsible Individual

Name License Number
CRYSTAL LEE LEE CROTEAU PRN434972

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
20509606

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: 05/22/2025 03:38:30 PM