black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

LAWRENCE MICHAEL ROSE

PRODUCER NON-RESIDENT

License Number:
PRN468705
Status:
First Licensure:
11/02/2023
Cancel Date:
None

Mailing:
SARATOGA SPRINGS, NY 12866
Phone:
+1 (303) 601-8267
Email:
larry.rose@siaa.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 11/02/2023

Agency

Name Issue Date License Number Expiration Date Cancel Date
DEFOREST GROUP INC
12/04/2023 AGN221723

Employer

Name Issue Date License Number Expiration Date Cancel Date
FOREMOST INSURANCE COMPANY GRAND RAPIDS, MICHIGAN
07/02/2024 PCF445
SELECTIVE INSURANCE COMPANY OF AMERICA
01/24/2024 PCF456095
SELECTIVE INSURANCE COMPANY OF NEW YORK
01/24/2024 PCF437
SELECTIVE INSURANCE COMPANY OF SOUTH CAROLINA
01/24/2024 PCF456097
SELECTIVE INSURANCE COMPANY OF THE SOUTHEAST
01/24/2024 PCF456098
SELECTIVE WAY INSURANCE COMPANY
01/24/2024 PCF456096
TRAVELERS PERSONAL INSURANCE COMPANY
03/18/2024 PCF201268

Authority

Description Issue Date Termination Date Status
CASUALTY 11/02/2023 Active
PROPERTY 11/02/2023 Active

Responsible For

Name License Number
DEFOREST GROUP INC AGN221723

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
16492138

Other Addresses

Address Type
SARATOGA SPRINGS, NY 12866
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: 05/15/2025 02:00:11 AM