DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Massom, Dawn	DOIID	1194955	NAIC NPN	19153590

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	3/23/2022		10/31/2025
Active	Non Resident	Agent	Property	3/23/2022		10/31/2025
* 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	08/15/2025	10/31/2025

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Acrisure Great Lakes Partners Insurance Services LLC	1271471	Agent - Casualty
Denied	Acrisure Great Lakes Partners Insurance Services LLC	1271471	Agent - Property
Denied	Acrisure LLC	696181	Agent - Casualty
Denied	Acrisure LLC	696181	Agent - Property