DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Theisen, Michael	DOIID	733833	NAIC NPN	6956908

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	8/5/2010	5/31/2017
Inactive	Non Resident	Agent	Property	8/5/2010	5/31/2017
* 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	Fireman's Fund Insurance Company	301423	Agent - Casualty	10/27/2010	12/8/2015
Inactive	Fireman's Fund Insurance Company	301423	Agent - Property	10/27/2010	12/8/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Swett & Crawford	513269	Agent - Property	10/28/2010	12/8/2015
Inactive	Swett & Crawford	513269	Agent - Casualty	10/28/2010	12/8/2015