DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Piaseczny, Matthew	DOIID	1015050	NAIC NPN	15936627

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	10/15/2018	1/31/2020
Inactive	Non Resident	Agent	Health	10/15/2018	1/31/2020
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	MassMutual Ascend Life Insurance Company	300320	Agent - Life	11/29/2019	1/31/2020
Inactive	Northwestern Mutual Life Insurance Company	300931	Agent - Health	10/17/2018	8/19/2019
Inactive	Northwestern Mutual Life Insurance Company	300931	Agent - Life	10/17/2018	8/19/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Securities America Inc.	400225	Agent - Health
Inactive	Securities America Inc.	400225	Agent - Life	11/29/2019	1/31/2020