DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Martin, Maribeth	DOIID	945926	NAIC NPN	11117822

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	2/24/2017	2/29/2020
Inactive	Non Resident	Agent	Property	2/24/2017	2/29/2020
Inactive	Non Resident	Agent	Life	2/24/2017	2/29/2020
Inactive	Non Resident	Agent	Health	2/24/2017	2/29/2020
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	9/7/2017	1/20/2020
* 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	Insurance Company of the State of Pennsylvania	300807	Agent - Health	7/30/2018	2/29/2020
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	7/30/2018	2/29/2020
Inactive	New Hampshire Insurance Company	301670	Agent - Health	7/30/2018	2/29/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aon Risk Services Central, Inc	502106	Agent - Health	9/20/2018	1/7/2020