black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

SHANE WILLIAM GUSTAFSON

PRODUCER NON-RESIDENT

License Number:
PRN443841
Status:
First Licensure:
02/11/2023
Cancel Date:
None

Mailing:
PIEDMONT, SC 29673
Phone:
+1 (864) 735-4616
Email:
sgustafson@blueridgespecialty.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 02/11/2023

Agency

Name Issue Date License Number Expiration Date Cancel Date
BLUE RIDGE SPECIALTY LLC
02/11/2023 AGN357032

Employer

Name Issue Date License Number Expiration Date Cancel Date
CONTINENTAL INDEMNITY COMPANY
02/15/2023 PCF131045
PENNSYLVANIA INSURANCE COMPANY
12/08/2023 PCF72859

Authority

Description Issue Date Termination Date Status
CASUALTY 02/11/2023 Active
PROPERTY 02/11/2023 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
19500410

Other Addresses

Address Type
601 E MCBEE AVE STE 204
GREENVILLE, SC 29601-2945
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: 12/11/2025 02:14:10 AM