DEPARTMENT OF INSURANCE

Name	Collentine, Timothy J	DOIID	339083	NAIC NPN	285936

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	4/22/1996	11/30/2012
Inactive	Non Resident	Agent	Property	8/15/2000	11/30/2012
Inactive	Non Resident	Agent	General Lines	4/22/1996	8/15/2000
Inactive	Non Resident	Agent	Life	4/22/1996	11/30/2012
Inactive	Non Resident	Agent	Casualty	8/15/2000	11/30/2012

*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	2935 N Ballard Rd Suite 2Appleton, WI 549118075
Residence	Not Public Information