DEPARTMENT OF INSURANCE

Name	Willett, Lori Counts	DOIID	589773	NAIC NPN	8100994

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Casualty	6/25/2004	11/30/2024
Active	Resident	Agent	Life	1/11/2005	11/30/2024
Active	Resident	Agent	Health	1/11/2005	11/30/2024
Active	Resident	Agent	Property	6/25/2004	11/30/2024

*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	09/15/2024	11/30/2024

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
Mailing	555 Stahr Rd Fancy Farm, KY 42039
Business / Home Office	Dennis Bradford State Farm Ins 301 Wyatt DriveMayfield, KY 42066

Phone Information

Type	Phone
Business / Home Office	(270) 247-4934