DEPARTMENT OF INSURANCE

Name	Ford, Jasmine	DOIID	1303031	NAIC NPN	20425318

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	10/4/2023		5/31/2026

*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
Business / Home Office	4600 Big Tree Way Apt 3q Greensboro, NC 274092783
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(704) 230-6335