DEPARTMENT OF INSURANCE

Name	Platinum Shield Insurance LLC	DOIID	1373349	NAIC NPN	21351008

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	11/20/2024		3/31/2026

*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	01/15/2026	03/31/2026

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date.

Address Information

Type	Address
Business / Home Office	8324 San Marcos Cir Castleton, IN 46256

Internet Information

Type	Address
Business Email	Derrick@platinum-shield.com

Phone Information

Type	Phone
Business / Home Office	(317) 771-4610