DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Islam, Khadijah	DOIID	1186480	NAIC NPN	5769614

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	2/4/2022		11/30/2024
Active	Non Resident	Agent	Casualty	2/4/2022		11/30/2024
* 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	09/15/2024	11/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	12/6/2023	2/19/2024
Inactive	Bristol West Insurance Company	301655	Agent - Property	12/6/2023	2/19/2024
Active	Dairyland Insurance Company	301370	Agent - Casualty	4/4/2022
Active	Dairyland Insurance Company	301370	Agent - Property	4/4/2022
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	12/6/2023	2/19/2024
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	12/6/2023	2/19/2024
Inactive	Travelers Personal Insurance Company	705785	Agent - Casualty	5/11/2023	2/28/2024
Inactive	Travelers Personal Insurance Company	705785	Agent - Property	5/11/2023	2/28/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Breathe Easy Insurance Solutions, LLC	1056193	Agent - Casualty	9/5/2023	2/2/2024
Inactive	Breathe Easy Insurance Solutions, LLC	1056193	Agent - Property	9/5/2023	2/2/2024