DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	De La Casa, Gomez	DOIID	595904	NAIC NPN	6078188

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	9/21/2004		9/30/2025
Active	Non Resident	Agent	Health	9/21/2004		9/30/2025
* 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	07/15/2025	09/30/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	2/17/2005	10/12/2020
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	2/17/2005	10/12/2020
Active	Guardian Life Insurance Company of America	301316	Agent - Health	2/17/2005
Active	Guardian Life Insurance Company of America	301316	Agent - Life	2/17/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Mesirow Ins Services Inc	510824	Agent - Life	2/17/2005	3/21/2025
Inactive	Mesirow Ins Services Inc	510824	Agent - Health	2/17/2005	3/21/2025