DEPARTMENT OF INSURANCE

Name	Williams, Derrick David	DOIID	1119539	NAIC NPN	2665134

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	Life	2/4/2021		7/31/2025
Active	Non Resident	Agent	Health	2/4/2021		7/31/2025

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

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	05/15/2025	07/31/2025

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date. Licensees subject to CE must complete CE requirements before Next Compliance Date in order to successfully complete the License Renewal Process.

Address Information

Type	Address
Residence	Not Public Information
Business / Home Office	24355 Creekside Dr # 802784 Santa Clarita, CA 91321

Internet Information

Type	Address
Business Email	NP2LICENSING@HUMANA.COM

Phone Information

Type	Phone
Business / Home Office	(877) 256-1640 Ext-11255