DEPARTMENT OF INSURANCE

Name	Bourbon City Benefits	DOIID	772621	NAIC NPN	16509958

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Resident	Agent	Health	1/12/2012	9/1/2015

*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	72 Colson Dr Russell Springs, KY 42642

Phone Information

Type	Phone
Business / Home Office	(502) 324-3006