black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

ELAINE MARIE SAMPSON

PRODUCER NON-RESIDENT

License Number:
PRN22235
Status:
First Licensure:
01/21/1988
Cancel Date:
None

Mailing:
WORCESTER, MA 01604
Phone:
+1 (508) 799-3998
Fax:
+1 (508) 799-2768
Email:
esamp48@aol.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 09/05/1991
*** NOT ACTIVE *** 08/01/1991 09/04/1991
PRODUCER NON-RESIDENT 01/21/1988 07/31/1991

Agency

None.

Employer

Name Issue Date License Number Expiration Date Cancel Date
FOREMOST INSURANCE COMPANY GRAND RAPIDS, MICHIGAN
05/17/2016 PCF445
HARLEYSVILLE INSURANCE COMPANY
08/27/2008 PCF129870
HARLEYSVILLE MUTUAL INSURANCE COMPANY
08/27/2008 PCF74622 05/01/2012
HARLEYSVILLE PREFERRED INSURANCE COMPANY
08/27/2008 PCF128998
HARLEYSVILLE WORCESTER INSURANCE COMPANY
09/05/1991 PCF908
NATIONWIDE GENERAL INSURANCE COMPANY
12/07/2018 PCF30
NATIONWIDE MUTUAL FIRE INSURANCE COMPANY
12/07/2018 PCF31 01/01/2023
NATIONWIDE MUTUAL INSURANCE COMPANY
09/16/2016 PCF32
SAFETY INDEMNITY INSURANCE COMPANY
10/21/2019 PCF246091
SAFETY INSURANCE COMPANY
10/21/2019 PCF246090
SAFETY PROPERTY AND CASUALTY INSURANCE COMPANY
10/21/2019 PCF246092

Authority

Description Issue Date Termination Date Status Additional Information
CASUALTY 09/05/1991 Active
PROPERTY 09/05/1991 Active
LIMITED TO HOME STATE 09/05/1991 07/01/1996 Terminated
Designated State

PROPERTY AND CASUALTY 01/01/1901 08/01/1991 Terminated

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
2280909

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: 05/15/2025 07:33:39 PM