DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Petersen, Glenn E	DOIID	912949	NAIC NPN	4546910

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	4/18/2016		7/31/2025
Active	Non Resident	Agent	Property	4/18/2016		7/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	4/9/2024		7/31/2025
* 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	05/15/2025	07/31/2025
Surplus Lines Broker	05/15/2025	07/31/2025

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	RSG Specialty, LLC	726176	Agent - Property
Denied	RSG Specialty, LLC	726176	Agent - Casualty