DEPARTMENT OF INSURANCE
Licensee Search Details
NameDomin, Derek MichaelDOIID1423307NAIC NPN12128264
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration DateDesignated Home State
ActiveNon ResidentAgentHealth9/17/2025 4/30/2028 
ActiveNon ResidentAgentLife9/17/2025 4/30/2028 
*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 Office6757 Cascade Rd Se Ste 212 Grand Rapids, MI 495466849
ResidenceNot Public Information
Internet Information
TypeAddress
Business Emailddomin@comcast.net
Phone Information
TypePhone
Business / Home Office(616) 633-1152

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