black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

OCCUSURE WORKERS' COMPENSATION SPECIALISTS LLC

NON-RESIDENT PRODUCER AGENCY

License Number:
AGN179623
Status:
First Licensure:
07/20/2010
Cancel Date:
None
Renewal Date:
04/01/2027

Street Location:
6 CADILLAC DR STE 370
BRENTWOOD, TN 37027-1048
Mailing:
6 CADILLAC DR STE 370
BRENTWOOD, TN 37027-1048
Phone:
+1 (615) 221-5403
Email:
jjennings@occusure.com

History

License Type Start Date End Date
NON-RESIDENT PRODUCER AGENCY 07/20/2010 04/01/2027

Employer

Name Issue Date License Number Expiration Date Cancel Date
ARCH INSURANCE COMPANY
02/14/2018 PCF62719
COREPOINTE INSURANCE COMPANY
04/17/2024 PCF398
MILFORD CASUALTY INSURANCE COMPANY
04/17/2024 PCF189489
SOUTHERN INSURANCE COMPANY
04/17/2024 PCF231481

Affiliated Agent

Name Issue Date License Number Expiration Date Cancel Date
COREY W. LILE
07/20/2010 PRN143344

Branch Office

None.

Supervised Entity

None.

Responsible Individual

Name License Number
COREY W. LILE PRN143344

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
8803625

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: 11/14/2025 08:13:19 PM