DEPARTMENT OF INSURANCE

Name	Chuck Berry Insurance Agency	DOIID	802103	NAIC NPN	16874268

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Active	Resident	Agent	Health	1/24/2013		3/31/2027
Active	Resident	Agent	Life	1/24/2013		3/31/2027

*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	01/15/2025	03/31/2025	03/12/2025	03/12/2025	Yes

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date.

Address Information

Type	Address
Business / Home Office	1795 Alysheba Way #4202 Lexington, KY 40509

Internet Information

Type	Address
Personal Email	chuck.berry.01@gmail.com
Business Email	chuckberryins@gmail.com

Phone Information

Type	Phone
Business / Home Office	(859) 523-5360