DEPARTMENT OF INSURANCE

Name	Petska, Timothy David	DOIID	747234	NAIC NPN	9038518

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Property	2/1/2011	5/31/2016
Inactive	Non Resident	Agent	Life	2/1/2011	5/31/2016
Inactive	Non Resident	Agent	Casualty	2/1/2011	5/31/2016

*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	Assuredpartners Of Ohio, Llc 285 Cozzins StColumbus, OH 432152334
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(614) 899-8503