DEPARTMENT OF INSURANCE

Name	Broad Street Brokerage Insurance Agency, LLC	DOIID	540067	NAIC NPN	5698361

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Non Resident	Agent	Health	1/3/2002	11/8/2024
Inactive	Non Resident	Agent	Life	1/3/2002	11/8/2024

*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	471 East Broad St. Columbus, OH 43215

Phone Information

Type	Phone
Business / Home Office	(614) 225-8679