DEPARTMENT OF INSURANCE

Name	Legacy Benefits Services	DOIID	1194192	NAIC NPN	18395636

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	3/18/2022	3/31/2024
Inactive	Non Resident	Agent	Life	3/18/2022	3/31/2024

*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	8164 Robin Hill Rd Newburgh, IN 476303086

Phone Information

Type	Phone
Business / Home Office	(812) 909-0751