DEPARTMENT OF INSURANCE

Name	Wilson, Teresa	DOIID	352507	NAIC NPN	5966487

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Administrator	Not Applicable	5/1/2000	9/30/2008
Active	Resident	Agent	Health	9/14/1993		9/30/2024
Active	Resident	Agent	Life	9/14/1993		9/30/2024
Inactive	Resident	Agent	Health Maintenance Organization	8/2/1995	3/1/2001

*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	07/15/2024	09/30/2024

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
Business / Home Office	2106 Belle Haven Blvd Bowling Green, KY 421047205
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(270) 781-0084