DEPARTMENT OF INSURANCE

Name	Prudhomme, Mary Rebecca	DOIID	848123	NAIC NPN	17256881

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	12/7/2018	4/30/2021
Pending Replacement	Non Resident	Agent	Property	5/26/2022		4/30/2025
Pending Replacement	Non Resident	Agent	Casualty	5/26/2022		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	5311 S La Rosa Dr Tempe, AZ 852831829
Residence	Not Public Information

Internet Information

Type	Address
Business Email	azsky17@yahoo.com

Phone Information

Type	Phone
Business / Home Office	(623) 205-7633