black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

GALLAGHER RE INC

NON-RESIDENT PRODUCER AGENCY

License Number:
AGN53324
Status:
First Licensure:
01/29/1998
Cancel Date:
None
Renewal Date:
04/01/2027

Street Location:
300 MADISON AVE FL 28
NEW YORK, NY 10017-6436
Mailing:
300 MADISON AVE FL 28
NEW YORK, NY 10017-6436
Phone:
+1 (212) 915-8336
Fax:
+1 (920) 449-7605
Email:
imelda_cornejo@ajg.com

History

License Type Start Date End Date
NON-RESIDENT PRODUCER AGENCY 01/29/1998 04/01/2027

Employer

Name Issue Date License Number Expiration Date Cancel Date
AXIS INSURANCE COMPANY
12/19/2016 PCF134278
NATIONWIDE LIFE INSURANCE COMPANY
01/16/2019 LHF29 04/03/2024
PRUDENTIAL INSURANCE COMPANY OF AMERICA
02/03/2015 LHF252
UNITEDHEALTHCARE INSURANCE COMPANY
12/14/2016 LHF700 08/12/2025
UNITEDHEALTHCARE OF NEW ENGLAND, INC.
11/01/2021 HMF393375 08/12/2025

Affiliated Agent

Name Issue Date License Number Expiration Date Cancel Date
JASON LORENZO ALVAREZ
12/28/2016 PRR280551
CHARLES ANDERSON BELCHER JR
02/01/2024 PRR382980
STOUGHTON BELL
01/25/2026 PRN538771
DONALD BRIGGS
12/23/2014 PRR138716
LISA DUNCAN
08/28/2025 PRN288849
SHAWN R. DUTREMBLE
12/06/2018 PRR322566
JAMES T. FALLON
12/23/2014 PRR70226
ROBERT BARRON FAST
12/23/2014 PRR79110
LEWIS HYLAND
03/31/2025 PRR510142
RACHEL JANE KUBIAK
06/10/2021 PRN385474
TIMOTHY IAN LACHANCE
08/20/2019 PRR336579
AUSTIN BRADFORD MCCRUM
02/01/2024 PRR430065
THOMAS E. MCGRATH
05/07/2024 PRN380194
KRISTYN M. MULRY
02/06/2019 PRR142798
JAMES S. ORSER
12/23/2014 PRR143124
JAMES P. POCHEPAN
08/10/2017 PRR291499
CAMDEN REGAN
07/16/2024 PRR487252
DOUGLAS STEELE
11/12/2014 PRN174142
SEAN PADRAIC WHELAN
03/05/2010 PRN175556

Branch Office

Name Issue Date License Number Expiration Date Cancel Date
GALLAGHER RE INC (PORTLAND ME)
12/23/2014 BRN243961

Supervised Entity

None.

Responsible Individual

Name License Number
ROBERT BARRON FAST PRR79110

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
1040331

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 04/27/2026 03:22:11 AM