black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

NIQUIA SHANTAE BENFORD

PRODUCER NON-RESIDENT

License Number:
PRN318556
Status:
First Licensure:
10/03/2018
Cancel Date:
None

Mailing:
RIVERDALE, GA 30274
Phone:
+1 (770) 866-1795
Fax:
+1 (770) 866-1795
Email:
nbenford102@yahoo.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 10/03/2018

Agency

Name Issue Date License Number Expiration Date Cancel Date
OPTAVISE LLC
10/22/2018 AGN167845

Employer

Name Issue Date License Number Expiration Date Cancel Date
BANKERS FIDELITY LIFE INSURANCE COMPANY
10/07/2018 LHF84789 05/28/2021
LUMICO LIFE INSURANCE COMPANY
02/20/2019 LHF300009 02/08/2023
PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY
11/14/2018 LHF250 08/21/2020
STARMOUNT LIFE INSURANCE COMPANY
11/14/2018 LHD131525 08/21/2020
TRUSTMARK INSURANCE COMPANY
09/25/2019 LHF132 06/09/2022
TRUSTMARK INSURANCE COMPANY
10/17/2022 LHF132
UNUM INSURANCE COMPANY
11/14/2018 LHD241 08/21/2020
UNUM LIFE INSURANCE COMPANY OF AMERICA
11/14/2018 LHD145 08/21/2020

Authority

Description Issue Date Termination Date Status
HEALTH 10/03/2018 Active
LIFE 10/03/2018 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
11170582

Other Addresses

Address Type
RIVERDALE, GA 30274
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: 05/14/2025 08:07:27 PM