black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

SHALON R. REGISTER

PRODUCER NON-RESIDENT

License Number:
PRN444681
Status:
First Licensure:
02/23/2023
Cancel Date:
None

Mailing:
MARIANNA, FL 32448
Phone:
+1 (336) 435-3568
Fax:
+1 (336) 435-0750
Email:
shalon.register@ngic.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 02/23/2023

Agency

Name Issue Date License Number Expiration Date Cancel Date
AFFINITY BROKERAGE LLC
02/23/2023 AGN55398 05/04/2023
CWI LLC
02/23/2023 AGN173565 05/04/2023
NATIONAL GENERAL INSURANCE MARKETING INC
02/23/2023 AGN43510 05/04/2023

Employer

Name Issue Date License Number Expiration Date Cancel Date
FOREMOST INSURANCE COMPANY GRAND RAPIDS, MICHIGAN
03/22/2023 PCF445 05/15/2023
NATIONAL SPECIALTY INSURANCE COMPANY
08/21/2023 PCF94585
STATE NATIONAL INSURANCE COMPANY INC.
08/21/2023 PCF75933

Authority

Description Issue Date Termination Date Status
CASUALTY 02/23/2023 Active
PROPERTY 02/23/2023 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
3536515

Other Addresses

Address Type
MARIANNA, FL 32448
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: 03/07/2026 03:07:06 AM