DEPARTMENT OF INSURANCE

Name	Hazelwood, Michael D	DOIID	343551	NAIC NPN	3310905

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	6/4/1993		8/31/2024
Active	Resident	Agent	Life	8/24/1993		8/31/2024
Active	Resident	Agent	Casualty	8/15/2000		8/31/2024
Active	Resident	Agent	Property	8/15/2000		8/31/2024
Inactive	Resident	Agent	General Lines	3/23/1994	8/15/2000
Active	Resident	Property & Casualty Consultant	Not Applicable	1/27/2021		8/31/2024

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	06/15/2024	08/31/2024
Property & Casualty Consultant	06/15/2024	08/31/2024

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	2111 U.S. Hwy 41 Norht Henderson, KY 42420
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(270) 830-8877