DEPARTMENT OF INSURANCE

Name	Ancillary Choice LLC	DOIID	1070423	NAIC NPN	19397907

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Resident	Administrator	Not Applicable	3/3/2020	3/31/2026
Active	Resident	Agent	Life	6/17/2026		3/31/2028

*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	10100 Linn Station Road Louisville, KY 40223

Internet Information

Type	Address
Business Email	danielle.jackson@deltadentalky.com

Phone Information

Type	Phone
Business / Home Office	(502) 736-4647