black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

DONALD MCCULLY

PRODUCER NON-RESIDENT

License Number:
PRN494602
Status:
First Licensure:
09/09/2024
Cancel Date:
None

Mailing:
CHICAGO, IL 60654
Phone:
+1 (703) 966-9797
Fax:
+1 (312) 989-4466
Email:
don@medicalcaptive.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 09/09/2024

Agency

Name Issue Date License Number Expiration Date Cancel Date
MEDICAL CAPTIVE UNDERWRITERS LLC
10/01/2024 AGN497233

Employer

Name Issue Date License Number Expiration Date Cancel Date
SYMETRA LIFE INSURANCE COMPANY
10/14/2024 LHF777

Authority

Description Issue Date Termination Date Status
HEALTH 09/09/2024 Active

Responsible For

Name License Number
MEDICAL CAPTIVE UNDERWRITERS LLC AGN497233

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
9055780

Other Addresses

Address Type
405 W SUPERIOR ST STE 604
CHICAGO, IL 60654-8561
Office

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: 03/14/2026 01:28:17 PM