DEPARTMENT OF INSURANCE

Name	Formick, Joseph Louis	DOIID	515828	NAIC NPN	2515914

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Non Resident	Agent	Life	12/6/2000	8/31/2004
Inactive	Non Resident	Agent	Health	12/6/2000	8/31/2004

*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
Residence	Not Public Information
Business / Home Office	3700 Park East Dr Beachwood, OH 44122

Phone Information

Type	Phone
Business / Home Office	(216) 292-7900
Fax	(216) 292-7902