DEPARTMENT OF INSURANCE

Name	Basham, Gwenda Lou	DOIID	333200	NAIC NPN	243540

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	7/5/1994	7/31/2012
Inactive	Non Resident	Agent	Casualty	4/25/2003	7/31/2012
Inactive	Non Resident	Agent	Health	7/5/1994	7/31/2012
Inactive	Non Resident	Agent	Property	4/25/2003	7/31/2012

*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	Mid-America Agency Services 1205 7th StHarlan, IA 51537
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(712) 755-9500