black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

TERRY L. GREEN

PRODUCER NON-RESIDENT

License Number:
PRN101504
Status:
First Licensure:
02/12/2004
Cancel Date:
None

Mailing:
LILBURN, GA 30047
Phone:
+1 (678) 344-9994
Fax:
+1 (678) 205-8041
Email:
tgreen@shisinc.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 02/12/2004

Agency

Name Issue Date License Number Expiration Date Cancel Date
TERRY L GREEN & ASSOC INC
07/12/2008 AGN155743

Employer

Name Issue Date License Number Expiration Date Cancel Date
ALLIED INSURANCE COMPANY OF AMERICA
09/24/2015 PCF216138 04/05/2016
AXIS INSURANCE COMPANY
07/07/2010 PCF134278
BERKLEY LIFE AND HEALTH INSURANCE COMPANY
11/09/2015 LHF14
GREAT AMERICAN INSURANCE COMPANY
05/05/2015 PCF764
NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA
10/19/2012 PCF527
NATIONWIDE LIFE INSURANCE COMPANY
11/10/2008 LHF29 09/26/2011
NATIONWIDE LIFE INSURANCE COMPANY
01/31/2013 LHF29 05/01/2013
NATIONWIDE LIFE INSURANCE COMPANY
03/24/2015 LHF29
NATIONWIDE MUTUAL INSURANCE COMPANY
11/10/2008 PCF32 05/01/2013
NATIONWIDE MUTUAL INSURANCE COMPANY
03/24/2015 PCF32
QBE INSURANCE CORPORATION
07/20/2004 PCF82307 06/30/2009
STARNET INSURANCE COMPANY
11/09/2015 PCF103936
UNITED STATES FIRE INSURANCE COMPANY
03/10/2014 PCF101256

Authority

Description Issue Date Termination Date Status
CASUALTY 02/12/2004 Active
HEALTH 02/12/2004 Active
LIFE 02/12/2004 Active
PROPERTY 02/12/2004 Active

Responsible For

Name License Number
TERRY L GREEN & ASSOC INC AGN155743

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
1248886

Other Addresses

Address Type
LILBURN, GA 30047
Office

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 05/15/2025 12:10:31 AM