DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Mangan, Thomas L	DOIID	722099	NAIC NPN	861666

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	10/7/2016		12/31/2024
Active	Non Resident	Agent	Health	10/7/2016		12/31/2024
* 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	10/15/2024	12/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	4/13/2017	1/30/2022
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	4/13/2017	1/30/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Acrisure Of California LLC	861366	Agent - Life	9/3/2021	12/1/2021
Inactive	Acrisure Of California LLC	861366	Agent - Health	9/3/2021	12/1/2021
Denied	Corporate Synergies Group LLC	618292	Agent - Life
Denied	Corporate Synergies Group LLC	618292	Agent - Health
Active	Embroker Ins Services LLC	901870	Agent - Life	10/24/2016
Active	Embroker Ins Services LLC	901870	Agent - Health	10/24/2016