DEPARTMENT OF INSURANCE

Name	Tolliver, Samuel C	DOIID	966522	NAIC NPN	18517639

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Property	1/12/2018	1/31/2019
Inactive	Non Resident	Agent	Health	9/6/2017	1/31/2019
Inactive	Non Resident	Agent	Casualty	1/12/2018	1/31/2019

*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
Business / Home Office	1124 S Clifton Ave Springfield, MO 658027788
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(417) 763-2877