black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

JOHNSON-WITKEMPER INC

NON-RESIDENT PRODUCER AGENCY

License Number:
AGN490061
Status:
First Licensure:
07/26/2024
Cancel Date:
None
Renewal Date:
04/01/2027

Street Location:
305 WASHINGTON ST
COLUMBUS, IN 47201-6743
Mailing:
305 WASHINGTON ST
COLUMBUS, IN 47201-6743
Phone:
+1 (812) 372-7829
Fax:
+1 (812) 372-0026
Email:
info@jwinsurance.com

History

License Type Start Date End Date
NON-RESIDENT PRODUCER AGENCY 07/26/2024 04/01/2027

Employer

Name Issue Date License Number Expiration Date Cancel Date
SELECTIVE INSURANCE COMPANY OF AMERICA
09/11/2024 PCF456095
SELECTIVE INSURANCE COMPANY OF NEW YORK
09/11/2024 PCF437
SELECTIVE INSURANCE COMPANY OF SOUTH CAROLINA
09/11/2024 PCF456097
SELECTIVE INSURANCE COMPANY OF THE SOUTHEAST
09/11/2024 PCF456098
SELECTIVE WAY INSURANCE COMPANY
09/11/2024 PCF456096

Affiliated Agent

Name Issue Date License Number Expiration Date Cancel Date
MARK D. THAYER
07/26/2024 PRN489787

Branch Office

None.

Supervised Entity

None.

Responsible Individual

Name License Number
MARK D. THAYER PRN489787

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
2087704

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: 05/23/2025 12:44:41 PM