DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Johnson, Mary Bertolasio	DOIID	1079124	NAIC NPN	7826496

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	3/24/2020		5/31/2026
Active	Non Resident	Agent	Health	2/25/2022		5/31/2026
Active	Non Resident	Agent	Casualty	3/24/2020		5/31/2026
Active	Non Resident	Agent	Life	2/25/2022		5/31/2026
Active	Non Resident	Surplus Lines Broker	Not Applicable	3/24/2020		5/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	03/15/2024	05/31/2024	04/16/2024	04/16/2024	Yes
Surplus Lines Broker	03/15/2024	05/31/2024	04/16/2024	04/16/2024	Yes

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Baldwin Krystyn Sherman Partners, LLC	638213	Surplus Lines Broker - Not Applicable	3/27/2020	9/13/2023