DEPARTMENT OF INSURANCE

Name	E. N. Dornbusch Agency Inc.	DOIID	398456	NAIC NPN	4684110

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Property	8/15/2000		3/31/2027
Active	Resident	Agent	Health	8/24/1993		3/31/2027
Active	Resident	Agent	Life	8/24/1993		3/31/2027
Active	Resident	Agent	Casualty	8/15/2000		3/31/2027
Inactive	Resident	Agent	General Lines	6/9/1993	8/15/2000
Inactive	Resident	Agent	Health Maintenance Organization	7/2/1997	3/1/2001

*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	01/15/2025	03/31/2025	03/13/2025	03/13/2025	Yes

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

Address Information

Type	Address
Business / Home Office	211 Grandview Drive Suite 207Ft Mitchell, KY 41017

Phone Information

Type	Phone
Business / Home Office	(859) 331-4404