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Name:  COSE, AMBER D License Number:  102621
Alias: 
Address:  MUTUAL INSURANCE
1575 BALDY AVE
NPN:  7712427
  POCATELLO, ID 83201-7117 Issued:  7/10/2003
    Expired:  10/31/2015
Business Phone:  (208) 237-9696 License Status: 
License Type: 
Inactive
Resident Producer
   


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