DEPARTMENT OF INSURANCE

Name	M B A Ins Agency Of Az Inc	DOIID	609379	NAIC NPN	1632430

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Non Resident	Agent	Casualty	5/27/2005	4/11/2017
Inactive	Non Resident	Agent	Property	5/27/2005	4/11/2017

*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.

Address Information

Type	Address
Business / Home Office	8383 E Evans Scottsdale, AZ 85260

Internet Information

Type	Address
Business Email	carlos@mbainsurance.net
Business Email	bert@mbainsurance.net

Phone Information

Type	Phone
Business / Home Office	(480) 946-1066