black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

MELISSA MARIE ROMAN

PRODUCER NON-RESIDENT

License Number:
PRN176942
Status:
First Licensure:
04/23/2010
Cancel Date:
None

Mailing:
GRANDVIEW HEIGHTS, OH 43212
Phone:
+1 (949) 534-6054
Fax:
+1 (855) 863-3606
Email:
petlicng@nationwide.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 04/23/2010

Agency

Name Issue Date License Number Expiration Date Cancel Date
DVM INSURANCE AGENCY
04/23/2010 AGN27317

Employer

Name Issue Date License Number Expiration Date Cancel Date
NATIONAL CASUALTY COMPANY
05/26/2010 PCF85

Authority

Description Issue Date Termination Date Status
CASUALTY 04/23/2010 Active
PROPERTY 04/23/2010 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
15739915

Other Addresses

Address Type
18303 N 144TH AVE
SURPRISE, AZ 85374-4239
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: 06/16/2025 07:20:48 AM