DEPARTMENT OF INSURANCE

Name	Wiegman Insurance	DOIID	959816	NAIC NPN	18467535

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Non Resident	Agent	Health	7/10/2017	2/2/2024
Inactive	Non Resident	Agent	Life	7/10/2017	2/2/2024

*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	914 Pennwood Dr New Albany, IN 47150

Internet Information

Type	Address
Business Email	matthewwiegman@seniorsourceinsurance.com - Bad Email-Correction requested

Phone Information

Type	Phone
Business / Home Office	(502) 645-4730