DEPARTMENT OF INSURANCE

Name	Champneys, Adam C	DOIID	1211271	NAIC NPN	17930772

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	6/16/2022		1/31/2025
Active	Non Resident	Agent	Life	6/16/2022		1/31/2025

*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	11/15/2024	01/31/2025

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	4904 Eisenhower Blvd Ste 350 Tampa, FL 336346357
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(813) 724-3061