DEPARTMENT OF INSURANCE

Name	Shook, Timothy C	DOIID	1041372	NAIC NPN	1752403

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Active	Non Resident	Agent	Health	5/22/2019		8/31/2026
Active	Non Resident	Agent	Life	5/22/2019		8/31/2026

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	06/15/2024	08/31/2024	06/12/2024	06/12/2024	Yes

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	9482 Wedgewood Blvd Ste 130 Powell, OH 430657263
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(513) 607-9505