DEPARTMENT OF INSURANCE

Name	Harrison, Micheal David	DOIID	1106665	NAIC NPN	11069787

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Active	Non Resident	Agent	Health	10/21/2020		6/30/2026

*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	04/15/2024	06/30/2024	06/12/2024	06/12/2024	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	371 S 200 W Apt 729 Salt Lake City, UT 841011827
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(801) 979-3825