DEPARTMENT OF INSURANCE
Affiliations
NameLarson, Benjamin TDOIID902609NAIC NPN17807649
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentCasualty12/23/20154/30/2018 
InactiveNon ResidentAgentProperty12/23/20154/30/2018 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveBristol West Insurance Company301655Agent - Casualty2/2/201611/3/2017
InactiveBristol West Insurance Company301655Agent - Property2/2/201611/3/2017
InactiveForemost Insurance Company Grand Rapids, Michigan301027Agent - Casualty2/2/20168/31/2017
InactiveForemost Insurance Company Grand Rapids, Michigan301027Agent - Property2/2/20168/31/2017
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveLeavitt Group Agency Assn LLC696306Agent - Property2/2/201611/3/2017
InactiveLeavitt Group Agency Assn LLC696306Agent - Casualty2/2/201611/3/2017

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