DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Mita, Shizuka	DOIID	1270661	NAIC NPN	19886567

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	4/24/2023		1/31/2027
Active	Non Resident	Agent	Health	4/24/2023		1/31/2027
* 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	11/15/2024	01/31/2025	11/08/2024	11/08/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Aetna Health Inc. (PA)	660717	Agent - Health	11/22/2024
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	11/22/2024
Active	Aetna Life Insurance Company	301140	Agent - Health	11/22/2024
Active	Allianz Life Insurance Company of North America	301791	Agent - Life	9/8/2023
Active	Nationwide Life and Annuity Insurance Company	300714	Agent - Health	10/25/2023
Active	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	10/25/2023
Active	SilverScript Insurance Company	663526	Agent - Health	11/22/2024
Active	Transamerica Life Insurance Company	300571	Agent - Health	5/3/2023
Active	Transamerica Life Insurance Company	300571	Agent - Life	5/3/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	World Financial Group Insurance Agency, LLC	400520	Agent - Life	5/3/2023
Active	World Financial Group Insurance Agency, LLC	400520	Agent - Health	5/3/2023