DEPARTMENT OF INSURANCE

Name	Pack, Shasta Renae	DOIID	336919	NAIC NPN	7185708

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Denied	Resident	Agent	Health
Denied	Resident	Agent	Life
Inactive	Resident	Agent	General Lines	11/3/1994	8/15/2000
Inactive	Resident	Agent	Property	8/15/2000	10/17/2002
Inactive	Resident	Agent	Casualty	8/15/2000	10/17/2002
Inactive	Resident	Agent	Assessment Chapter 299	10/15/1999	12/1/2000

*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	P.O. Box 8157 108 Pasadena Drive Suite CLexington, KY 40533