DEPARTMENT OF INSURANCE

Name	Ph Brough Inc	DOIID	767193	NAIC NPN	8675307

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	Health	10/21/2011		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	3215 N. Washington Road Ft. Wayne, IN 46802

Internet Information

Type	Address
Business Email	slybobby@frontier.com

Phone Information

Type	Phone
Business / Home Office	(260) 434-0662