DEPARTMENT OF INSURANCE

Name	Chism, Shelby E	DOIID	900644	NAIC NPN	17788252

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	Property	12/1/2015	4/26/2019
Inactive	Non Resident	Agent	Casualty	12/1/2015	4/26/2019

*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	111 Congressional Blvd Ste 100 Carmel, IN 460325638

Phone Information

Type	Phone
Business / Home Office	(317) 848-6650