DEPARTMENT OF INSURANCE

Name	Kaplan, Chanan	DOIID	721236	NAIC NPN	977291

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	Health	4/15/2021	12/31/2022
Inactive	Non Resident	Agent	Life	4/15/2021	12/31/2022

*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	C/O Fairmont Insurance Brokers Ltd 1600 60th StBrooklyn, NY 11204

Phone Information

Type	Phone
Business / Home Office	(718) 232-3300 Ext-167