DEPARTMENT OF INSURANCE

Name	Bashaw, Gary R	DOIID	345710	NAIC NPN	1583879

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	9/7/1994		6/30/2025
Active	Non Resident	Agent	Health	9/7/1994		6/30/2025
Inactive	Non Resident	Agent	Health Maintenance Organization	12/4/1997	3/1/2001
Inactive	Non Resident	Agent	Prepaid Dental Plan	12/7/1998	3/1/2001

*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	6694 Amsterdam Drive Middletown, OH 45044