DEPARTMENT OF INSURANCE
Affiliations
NamePerez, Latisha EbbonieDOIID1373970NAIC NPN14588123
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentHealth11/25/2024 6/30/2026
ActiveNon ResidentAgentProperty11/25/2024 6/30/2026
ActiveNon ResidentAgentCasualty11/25/2024 6/30/2026
ActiveNon ResidentAgentLife11/25/2024 6/30/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent04/15/202606/30/2026   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveAAA Life Insurance Company300287Agent - Health12/6/2024 
ActiveAAA Life Insurance Company300287Agent - Life12/6/2024 
ActiveAmerican Modern Property and Casualty Insurance Company301954Agent - Casualty12/12/2024 
ActiveAmerican Modern Property and Casualty Insurance Company301954Agent - Property12/12/2024 
InactiveAmerican Strategic Insurance Corp883540Agent - Casualty11/29/202412/19/2024
InactiveAmerican Strategic Insurance Corp883540Agent - Property11/29/202412/19/2024
ActiveBristol West Insurance Company301655Agent - Casualty12/16/2024 
ActiveBristol West Insurance Company301655Agent - Property12/16/2024 
ActiveCSAA Fire & Casualty Insurance Company606666Agent - Casualty12/10/2024 
ActiveCSAA Fire & Casualty Insurance Company606666Agent - Property12/10/2024 
ActiveCSAA General Insurance Company606675Agent - Casualty12/10/2024 
ActiveCSAA General Insurance Company606675Agent - Property12/10/2024 
ActiveForemost Insurance Company Grand Rapids, Michigan301027Agent - Casualty12/16/2024 
ActiveForemost Insurance Company Grand Rapids, Michigan301027Agent - Property12/16/2024 
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveAca Club Insurance Agency, Inc.1033550Agent - Casualty12/5/2024 
ActiveAca Club Insurance Agency, Inc.1033550Agent - Life12/6/2024 
ActiveAca Club Insurance Agency, Inc.1033550Agent - Health12/6/2024 
ActiveAca Club Insurance Agency, Inc.1033550Agent - Property12/5/2024 

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