DEPARTMENT OF INSURANCE

Name	Foreman, Khalilah Renee Muhammad	DOIID	821815	NAIC NPN	17041325

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	Personal Lines	10/23/2014	4/30/2017
Pending Replacement	Non Resident	Agent	Health	11/4/2022		4/30/2025

*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	02/15/2025	04/30/2025

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date. Licensees subject to CE must complete CE requirements before Next Compliance Date in order to successfully complete the License Renewal Process.

Address Information

Type	Address
Business / Home Office	1415 Highway 85 N Ste 310-538 Fayetteville, GA 302147738
Residence	Not Public Information

Internet Information

Type	Address
Business Email	khalilah.muhammadforeman@elevancehealth.com

Phone Information

Type	Phone
Business / Home Office	(833) 552-0268