DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Maciszewski, Dorota	DOIID	1059409	NAIC NPN	13373566

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Pending Replacement	Non Resident	Agent	Casualty	10/7/2019		4/30/2026
Pending Replacement	Non Resident	Agent	Property	10/7/2019		4/30/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dairyland Insurance Company	301370	Agent - Casualty	10/9/2019	10/21/2025
Inactive	Dairyland Insurance Company	301370	Agent - Property	10/9/2019	10/21/2025
Pending Replacement	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	4/1/2020
Pending Replacement	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	4/1/2020
Inactive	Sentry Select Insurance Company	301648	Agent - Casualty	10/9/2019	10/21/2025
Inactive	Sentry Select Insurance Company	301648	Agent - Property	10/9/2019	10/21/2025

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Parker Stevens Agency LLC	558419	Agent - Casualty	1/7/2022	12/17/2025
Inactive	Parker Stevens Agency LLC	558419	Agent - Property	1/7/2022	12/17/2025