DEPARTMENT OF INSURANCE
Licensee Search Details
NameBurlingame, Gary ADOIID963765NAIC NPN1884450
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration DateDesignated Home State
ActiveNon ResidentAgentProperty10/8/2021 6/30/2026 
ActiveNon ResidentAgentHealth10/8/2021 6/30/2026 
ActiveNon ResidentAgentCasualty10/8/2021 6/30/2026 
ActiveNon ResidentAgentLife10/8/2021 6/30/2026 
*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
TypeAddress
Business / Home Office1600 Pine Tree Ln Apt 29 Dayton, OH 454492570
ResidenceNot Public Information
Internet Information
TypeAddress
Business Emailgburlingame@qw-corp.com
Phone Information
TypePhone
Business / Home Office(937) 776-3942

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