DEPARTMENT OF INSURANCE
Affiliations
NamePetree, Mitchell EdwardDOIID1223786NAIC NPN18758996
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentLife7/16/2024 2/29/2028
ActiveNon ResidentAgentCasualty7/16/2024 2/29/2028
ActiveNon ResidentAgentProperty7/16/2024 2/29/2028
ActiveNon ResidentAgentHealth7/16/2024 2/29/2028
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
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
InactiveMolina Healthcare of Kentucky, Inc.1035856Agent - Health7/23/20242/4/2026
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

© Commonwealth of Kentucky. All rights reserved.