DEPARTMENT OF INSURANCE

Name	Hizy, Michael	DOIID	893649	NAIC NPN	17312212

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	9/30/2015	7/31/2017
Inactive	Non Resident	Agent	Life	9/30/2015	7/31/2017

*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	999 Ne 23rd Dr Apt 105 Wilton Manors, FL 333051257
Residence	Not Public Information

Internet Information

Type	Address
Business Email	hizymus@gmail.com

Phone Information

Type	Phone
Business / Home Office	(321) 215-1466