DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Gorham, Mitchell	DOIID	957548	NAIC NPN	10144154

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	6/15/2017	8/31/2019
Inactive	Non Resident	Agent	Health	6/15/2017	8/31/2019
Inactive	Non Resident	Agent	Life	6/15/2017	8/31/2019
Inactive	Non Resident	Agent	Casualty	6/15/2017	8/31/2019
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Usi Insurance Services LLC	669260	Agent - Life
Denied	Usi Insurance Services LLC	669260	Agent - Health
Denied	Usi Insurance Services LLC	669260	Agent - Property
Denied	Usi Insurance Services LLC	669260	Agent - Casualty