DEPARTMENT OF INSURANCE
Licensee Search Details
NameBlack, Mary WDOIID1159079NAIC NPN18721173
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration DateDesignated Home State
ActiveNon ResidentAgentLife9/15/2021 7/31/2026 
*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
TypeAddress
Business / Home Office5051 Tildy Ln Ammon, ID 834016032
ResidenceNot Public Information
Internet Information
TypeAddress
Business EmailMBLACK7718@GMAIL.COM
Phone Information
TypePhone
Business / Home Office(818) 879-9514

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