DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Green, Donald E	DOIID	571269	NAIC NPN	3328460

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	6/26/2003	3/31/2023
Inactive	Non Resident	Agent	Health	6/26/2003	3/31/2023
Inactive	Non Resident	Agent	Casualty	6/26/2003	3/31/2023
Inactive	Non Resident	Agent	Personal Lines	6/26/2003	3/31/2023
Inactive	Non Resident	Agent	Property	6/26/2003	3/31/2023
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	1/31/2008	3/31/2011
* 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

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	4/4/2012	9/6/2012
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	4/4/2012	9/6/2012
Inactive	Medical Protective Company (The)	301207	Agent - Casualty	8/9/2006	3/31/2023
Inactive	Medical Protective Company (The)	301207	Agent - Property	8/9/2006	3/31/2023
Inactive	Medicus Insurance Company	750731	Agent - Casualty	11/5/2012	1/1/2018
Inactive	NORCAL Insurance Company	301971	Agent - Casualty	3/19/2019	3/31/2023
Inactive	Openly Insurance Company	501694	Agent - Casualty	5/7/2007	6/27/2013
Inactive	Openly Insurance Company	501694	Agent - Property	5/7/2007	6/27/2013
Inactive	ProAssurance Casualty Company	300928	Agent - Casualty	3/28/2011	3/31/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Associated Insurance Agency, Incorporated of Ohio	633282	Agent - Casualty	4/24/2007	11/20/2020
Inactive	Associated Insurance Agency, Incorporated of Ohio	633282	Agent - Property	4/24/2007	11/20/2020
Inactive	Shepherd Insurance, LLC	774397	Agent - Casualty	11/18/2019	2/14/2022
Denied	Shepherd Insurance, LLC	774397	Agent - Health
Denied	Shepherd Insurance, LLC	774397	Agent - Life
Inactive	Shepherd Insurance, LLC	774397	Agent - Property	11/18/2019	2/14/2022