DEPARTMENT OF INSURANCE
Course Attendance Information
PR01542: Benefit Plans of America
Experior Provider Number: S16532 
Provider Type: Independent
Certification Date: 7/15/2010

Address: 20236 Hague Road
Noblesville, IN 46062
Contact: Jillian Crowder
Telephone: 317-776-6770 EXT. 331
Status: Active
Termination Date: N/A
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Course Attendees
Course Name :  MEDICARE IRMAA DEMYSTIFIED WEBINAR
DOI IDNameCompletion Date Compliance Date
307435 Sutherlin, Donnie Rex 06/25/2026 01/31/2027
544653 Harris, Allison Michele 06/25/2026 02/29/2028
981056 Kirby, Nicole 06/25/2026 08/31/2027
563077 Southwood, Mas Lloyd 03/26/2026 06/30/2027
824180 Hines, Richard Roy 03/26/2026 05/31/2027
343160 Burk, Timothy C 03/26/2026 03/31/2027

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