DEPARTMENT OF INSURANCE

Name	Provident Insurance Agency, LLC	DOIID	759825	NAIC NPN	16326374

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Resident	Agent	Casualty	8/24/2011	10/1/2012
Inactive	Resident	Agent	Property	8/24/2011	10/1/2012

*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	9509 Us Highway 42 Suite #108 Prospect, KY 40059

Phone Information

Type	Phone
Business / Home Office	(502) 228-8974