DEPARTMENT OF INSURANCE

Name	Evergreen Insurance Group	DOIID	1213149	NAIC NPN	20376510

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Resident	Agent	Life	6/25/2022	3/31/2024
Inactive	Resident	Agent	Health	6/25/2022	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	710 Flat Rock Road Louisville, KY 40245

Internet Information

Type	Address
Business Email	kim@evergreeninsurancegroup.com

Phone Information

Type	Phone
Business / Home Office	(502) 263-9408