Capitola, CA
License data updated
Jul 25, 2025Suspended — Workers' Comp
May 9, 2025Primary Status: CLEAR Work Comp Susp
Workers' comp coverage changed
May 9, 2025Workers' comp suspension pending
Mar 25, 2025Secondary Status: WC Susp Pending
Workers' comp coverage obtained
Aug 21, 2024Mailing Address: 308 HILL ST APT #1 308 HILL ST APT 1
Expiration Date: 2024-05-31 2026-05-31
Workers Comp Policy Number: A09516447
Workers Comp Effective Date: 2021-12-01 2024-08-20
Workers Comp Expiration Date: 2025-03-20
Workers Comp Insurance Company: MID-CENTURY INSURANCE COMPANY
Workers Comp Coverage Type: Exempt Workers' Compensation Insurance
License issued
May 2, 2022