DEPARTMENT OF INSURANCE
Affiliations
NameSupan, Mitra DOIID980856NAIC NPN18661850
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentLife1/5/20185/31/2019 
InactiveNon ResidentAgentHealth1/5/20185/31/2019 
* 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
InactiveFreedom Life Insurance Company of America300074Agent - Health1/20/20182/26/2019
InactiveFreedom Life Insurance Company of America300074Agent - Life1/20/20182/26/2019
InactiveLifeShield National Insurance Company737111Agent - Health3/26/20195/31/2019
InactiveLumico Life Insurance Company300354Agent - Health9/12/201811/15/2018
InactiveLumico Life Insurance Company300354Agent - Life4/1/20195/31/2019
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
DeniedHealth Plan Intermediaries Holdings786463Agent - Health  
InactiveUshealth Advisors Llc713288Agent - Health1/20/20182/26/2019
InactiveUshealth Advisors Llc713288Agent - Life1/20/20182/26/2019

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