DEPARTMENT OF INSURANCE

Affiliations

Name	American Select Insurance Group LLC	DOIID	1417075	NAIC NPN	21685726

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	8/18/2025		3/31/2027
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Gonzalez, Mario	1045113	Agent - Health	8/18/2025