DEPARTMENT OF INSURANCE

Name	King-Forman Insurance Agency Inc	DOIID	1030147	NAIC NPN	2106384

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	2/25/2019	3/31/2023
Inactive	Non Resident	Agent	Property	2/25/2019	3/31/2023

*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	2604 E Dempster Ste 501 Park Ridge, IL 60068

Phone Information

Type	Phone
Business / Home Office	(847) 298-0100