DEPARTMENT OF INSURANCE

Name	Reise, Mitchell T	DOIID	1116978	NAIC NPN	18229508

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	1/15/2021		10/31/2025

*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
Business / Home Office	3162 Sweetwater Oaks Dr S Jacksonville, FL 322237276
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(505) 250-3813