DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Lopez Jr, Mitchell	DOIID	663837	NAIC NPN	7285597

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	9/13/2007	5/2/2018
Inactive	Non Resident	Agent	Casualty	9/13/2007	5/2/2018
* 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	21st Century North America Insurance Company	300884	Agent - Casualty	10/16/2007	1/24/2017
Inactive	21st Century North America Insurance Company	300884	Agent - Property	10/16/2007	1/24/2017
Inactive	American Home Assurance Company	300246	Agent - Casualty	10/16/2007	9/15/2009
Inactive	American Home Assurance Company	300246	Agent - Property	10/16/2007	9/15/2009
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	2/6/2016	1/11/2018
Inactive	Bristol West Insurance Company	301655	Agent - Property	2/6/2016	1/11/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Foremost Express Insurance Agency Inc.	515334	Agent - Property	12/18/2017	1/11/2018
Inactive	Foremost Express Insurance Agency Inc.	515334	Agent - Casualty	12/18/2017	1/11/2018