black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

KEVIN A. ELLIOTT

PRODUCER NON-RESIDENT

License Number:
PRN155290
Status:
First Licensure:
06/27/2008
Cancel Date:
None

Mailing:
WEST BRANCH, MI 48661
Phone:
+1 (989) 345-0200 x2322
Fax:
+1 (989) 345-0232
Email:
kevin@dieboldinsurance.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 06/27/2008

Agency

Name Issue Date License Number Expiration Date Cancel Date
HARTZ INS AGENCY LLC
06/24/2016 AGN270045
TAWAS BAY INS AGENCY LLC
10/02/2008 AGN158620 07/01/2013
TAWAS BAY INS AGENCY LLC
11/13/2015 AGN158620

Employer

Name Issue Date License Number Expiration Date Cancel Date
THE CINCINNATI LIFE INSURANCE COMPANY
12/29/2015 LHF75044
HUMANA INSURANCE COMPANY
12/22/2009 LHF980 09/22/2012
MAINE DENTAL SERVICE CORP
11/01/2008 NPD29330
MAINE EMPLOYERS MUTUAL INSURANCE COMPANY
09/26/2017 PCD35999
MEMIC INDEMNITY COMPANY
09/26/2017 PCF153927
NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA
06/13/2016 PCF527
TRAVELERS CASUALTY AND SURETY COMPANY
09/11/2019 PCF348
VISION SERVICE PLAN INSURANCE COMPANY
05/13/2016 LHF47545

Authority

Description Issue Date Termination Date Status
CASUALTY 06/27/2008 Active
HEALTH 06/27/2008 Active
LIFE 06/27/2008 Active
PROPERTY 06/27/2008 Active
INDEPENDENT PRODUCER 10/04/2008 09/28/2011 Terminated

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
540938

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: 05/19/2025 11:27:40 AM