DEPARTMENT OF INSURANCE

Name	Vandervort, Charles K	DOIID	378267	NAIC NPN	361231

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Property	8/15/2000	4/2/2019
Inactive	Non Resident	Agent	General Lines	8/21/1989	8/15/2000
Inactive	Non Resident	Agent	Life	4/24/2012	4/2/2019
Inactive	Non Resident	Agent	Casualty	8/15/2000	4/2/2019
Inactive	Non Resident	Agent	Health	4/24/2012	4/2/2019

*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. 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	2333 Rombach Ave Wilmington, OH 45177

Phone Information

Type	Phone
Business / Home Office	(937) 382-2546