DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Kearns, Michael Douglas	DOIID	714881	NAIC NPN	15031548

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Denied	Resident	Agent	Health
Inactive	Resident	Agent	Property	1/7/2014	10/1/2017
Inactive	Resident	Agent	Casualty	1/7/2014	10/1/2017
Inactive	Resident	Agent	Life	1/7/2014	10/1/2017
* 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	State Automobile Mutual Insurance Company	301824	Agent - Casualty	9/6/2011	10/1/2011
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Property	9/6/2011	10/1/2011
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	9/10/2016	11/14/2017
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	9/6/2011	10/1/2011
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	9/6/2011	10/1/2011
Inactive	West Bend Insurance Company	672974	Agent - Casualty	11/18/2014	10/1/2017
Inactive	West Bend Insurance Company	672974	Agent - Property	11/18/2014	10/1/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	M & J Insurance Service Inc.	399250	Agent - Casualty	9/6/2011	10/1/2011
Inactive	M & J Insurance Service Inc.	399250	Agent - Property	9/6/2011	10/1/2011
Denied	Provenance Specialty Ins Agency LLC	714228	Agent - Life