DEPARTMENT OF INSURANCE

Name	Derigiotis, David A	DOIID	1248564	NAIC NPN	17503743

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	12/25/2022	10/31/2025
Active	Non Resident	Agent	Casualty	12/25/2022	10/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	3/17/2023	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	30833 Northwestern Hwy Farmington Hills, MI 48334
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(248) 539-6041