DEPARTMENT OF INSURANCE

Name	Mittan Jr, Raymond Delbert	DOIID	393158	NAIC NPN	355364

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	12/30/2013	5/31/2015
Inactive	Non Resident	Agent	Prepaid Dental Plan	4/26/1996	8/9/1999
Inactive	Non Resident	Agent	Life	9/15/1992	7/31/2003

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

No License Renewal Information

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date. Licensees subject to CE must complete CE requirements before Next Compliance Date in order to successfully complete the License Renewal Process.

Address Information

Type	Address
Residence	Not Public Information
Business / Home Office	Ae Insurance 800 Market St Ste 200Chattanooga, TN 374022677

Phone Information

Type	Phone
Business / Home Office	(423) 424-0586