DEPARTMENT OF INSURANCE

Name	Bloom Insurance Agency LLC	DOIID	664017	NAIC NPN	9567860

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Active	Non Resident	Agent	Life	4/1/2009		3/31/2027
Active	Non Resident	Agent	Health	4/1/2008		3/31/2027

*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.

Address Information

Type	Address
Business / Home Office	1565 S Piazza Dr Bloomington, IN 474015578

Internet Information

Type	Address
Business Email	LICENSING@BLOOMINSURANCEAGENCY.COM - Bad Email-Correction requested

Phone Information

Type	Phone
Business / Home Office	(812) 650-5807 Ext-4110