black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

JERRI ANN WILDHABER

PRODUCER NON-RESIDENT

License Number:
PRN483240
Status:
First Licensure:
05/02/2024
Cancel Date:
None

Mailing:
LOOSE CREEK, MO 65054
Phone:
+1 (573) 636-8752
Fax:
+1 (573) 634-5770
Email:
jerri@mdis4dds.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 05/02/2024

Agency

Name Issue Date License Number Expiration Date Cancel Date
MISSOURI DENTAL INSURANCE SERVICES, INC
05/04/2024 AGN483363

Employer

Name Issue Date License Number Expiration Date Cancel Date
MEDICAL PROTECTIVE COMPANY (THE)
05/06/2024 PCF47861

Authority

Description Issue Date Termination Date Status
CASUALTY 05/02/2024 Active
HEALTH 05/02/2024 Active
LIFE 05/02/2024 Active
PROPERTY 05/02/2024 Active

Responsible For

Name License Number
MISSOURI DENTAL INSURANCE SERVICES, INC AGN483363

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
8740994

Other Addresses

Address Type
MDIS
3340 AMERICAN AVE STE E
JEFFERSON CITY, MO 65109-1088
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: 05/23/2025 02:36:44 PM