DEPARTMENT OF INSURANCE

Name	Palacios, Harold	DOIID	915309	NAIC NPN	8790899

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Active	Non Resident	Agent	Health	8/11/2021		3/31/2025

*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	01/15/2025	03/31/2025

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	2310 W Orion Way Apt 1 West Valley City, UT 841196133
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(704) 496-6000