DEPARTMENT OF INSURANCE

Name	Small, Patrick S	DOIID	510004	NAIC NPN	765867

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	8/15/2000		5/31/2026
Active	Non Resident	Agent	Life	12/31/2008		5/31/2026
Active	Non Resident	Agent	Health	12/31/2008		5/31/2026
Active	Non Resident	Agent	Casualty	8/15/2000		5/31/2026
Inactive	Non Resident	Agent	General Lines	6/14/2000	8/15/2000
Active	Non Resident	Surplus Lines Broker	Not Applicable	4/5/2004		5/31/2026

*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	03/15/2024	05/31/2024	03/21/2024	03/21/2024	Yes
Surplus Lines Broker	03/15/2024	05/31/2024	03/21/2024	03/21/2024	Yes

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
Business / Home Office	566 W Adams St Ste 200 Chicago, IL 606615792
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(973) 631-7575
Fax	(312) 381-6224