black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

MICHELLE R. KOOISTRA

PRODUCER NON-RESIDENT

License Number:
PRN215477
Status:
First Licensure:
04/16/2013
Cancel Date:
None

Mailing:
WYOMING, MI 49519
Phone:
+1 (800) 748-0351
Fax:
+1 (800) 847-3129
Email:
insurancelicensing@acrisure.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 04/16/2013

Agency

Name Issue Date License Number Expiration Date Cancel Date
ACRISURE GREAT LAKES PARTNERS INSURANCE SERVICES, LLC
01/23/2025 AGN450447
ACRISURE LLC
04/16/2013 AGN160630 01/23/2025

Employer

Name Issue Date License Number Expiration Date Cancel Date
ALLIED INSURANCE COMPANY OF AMERICA
04/12/2017 PCF216138 09/25/2023
ALLIED PROPERTY AND CASUALTY INSURANCE COMPANY
04/12/2017 PCF223935
AMCO INSURANCE COMPANY
04/12/2017 PCF223938
BRISTOL WEST INSURANCE COMPANY
02/21/2018 PCF78370
DEPOSITORS INSURANCE COMPANY
04/12/2017 PCF223940
FOREMOST INSURANCE COMPANY GRAND RAPIDS, MICHIGAN
02/21/2018 PCF445
NATIONWIDE ASSURANCE COMPANY
10/05/2021 PCF38952
NATIONWIDE GENERAL INSURANCE COMPANY
08/28/2018 PCF30 09/25/2023
NATIONWIDE INSURANCE COMPANY OF AMERICA
10/05/2021 PCF422
NATIONWIDE MUTUAL FIRE INSURANCE COMPANY
08/28/2018 PCF31 01/01/2023
NATIONWIDE MUTUAL INSURANCE COMPANY
08/28/2018 PCF32
NATIONWIDE PROPERTY & CASUALTY INSURANCE COMPANY
10/05/2021 PCF151089

Authority

Description Issue Date Termination Date Status
CASUALTY 04/16/2013 Active
PROPERTY 04/16/2013 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
998255

Other Addresses

Address Type
4808 BROADMOOR AVE SE
KENTWOOD, MI 49512-5306
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: 05/20/2025 11:51:32 AM