DEPARTMENT OF INSURANCE
Affiliations
NamePetree, Mitchell EdwardDOIID1223786NAIC NPN18758996
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentHealth7/16/2024 2/28/2026
ActiveNon ResidentAgentCasualty7/16/2024 2/28/2026
ActiveNon ResidentAgentLife7/16/2024 2/28/2026
ActiveNon ResidentAgentProperty7/16/2024 2/28/2026
* 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
Agent12/15/202502/28/2026   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAmGUARD Insurance Company500010Agent - Casualty8/29/20222/29/2024
InactiveAmGUARD Insurance Company500010Agent - Property8/29/20222/29/2024
ActiveMolina Healthcare of Kentucky, Inc.1035856Agent - Health7/23/2024 
InactiveNorGUARD Insurance Company500015Agent - Casualty8/29/20222/29/2024
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveRocky Mountain West Insurance LLC1128326Agent - Casualty8/29/20222/29/2024
InactiveRocky Mountain West Insurance LLC1128326Agent - Property8/29/20222/29/2024

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