black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

AMARIS NICOLE BLASEK

PRODUCER NON-RESIDENT

License Number:
PRN290057
Status:
First Licensure:
07/18/2017
Cancel Date:
None

Mailing:
FAYETTEVILLE, OH 45118
Phone:
+1 (800) 543-2644 x5740
Fax:
+1 (513) 388-5937
Email:
ablasek@amig.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 07/18/2017

Agency

Name Issue Date License Number Expiration Date Cancel Date
ATLAS INSURANCE AGENCY INC
07/18/2017 AGN60400

Employer

Name Issue Date License Number Expiration Date Cancel Date
AMERICAN MODERN HOME INSURANCE COMPANY
07/21/2017 PCF808 10/28/2021
AMERICAN MODERN PROPERTY & CASUALTY INSURANCE COMPANY
09/29/2017 PCF234561
AMERICAN MODERN SELECT INSURANCE COMPANY
07/21/2017 PCF123448 10/28/2021

Authority

Description Issue Date Termination Date Status
CASUALTY 07/18/2017 Active
PROPERTY 07/18/2017 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
18450564

Other Addresses

Address Type
7000 MIDLAND BLVD
AMELIA, OH 45102-2608
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: 05/24/2025 08:24:00 AM