DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Gross, David Michael	DOIID	1277550	NAIC NPN	4592557

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	5/31/2023		8/31/2026
Active	Non Resident	Agent	Casualty	5/31/2023		8/31/2026
Active	Non Resident	Surplus Lines Broker	Not Applicable	6/6/2023		8/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Burns & Wilcox Ltd	525929	Agent - Casualty
Denied	Burns & Wilcox Ltd	525929	Agent - Property
Active	Burns & Wilcox Ltd	525929	Surplus Lines Broker - Not Applicable	7/28/2023