DEPARTMENT OF INSURANCE

Name	Wassom, Grant	DOIID	1224326	NAIC NPN	20433180

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Active	Resident	Agent	Life	9/14/2022		10/31/2025
Active	Resident	Agent	Health	9/14/2022		10/31/2025

*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
Residence	Not Public Information
Business / Home Office	1750 Scottsville Rd, Unit 4 Bowling Green, KY 42104

Phone Information

Type	Phone
Business / Home Office	(859) 250-9805