DEPARTMENT OF INSURANCE

Name	Benjamin, Netje D	DOIID	822084	NAIC NPN	6611950

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	9/26/2013	4/30/2017
Inactive	Non Resident	Agent	Health	9/26/2013	4/30/2017
Denied	Non Resident	Life Settlement Provider	Not Applicable

*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
Business / Home Office	640 Thompson Rd Pegram, TN 371432413
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(615) 290-7896