DEPARTMENT OF INSURANCE

Name	Northern Legacy Insurance Agency	DOIID	1438556	NAIC NPN	21166963

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Active	Non Resident	Agent	Health	12/10/2025		3/31/2027
Active	Non Resident	Agent	Life	12/10/2025		3/31/2027

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

No License Renewal Information

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date.

Address Information

Type	Address
Business / Home Office	501 Se 2nd Street Apt 643 Fort Lauderdale, FL 33301

Internet Information

Type	Address
Business Email	DAVIDJOHNBRAZELLJR@GMAIL.COM

Phone Information

Type	Phone
Business / Home Office	(315) 345-1743