DEPARTMENT OF INSURANCE

Name	Johnson, Petagay	DOIID	927559	NAIC NPN	18061005

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	9/1/2016		5/31/2025

*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	1000 Nw 57th Ct Ste 500 Miami, FL 331263293
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(877) 256-1640