DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Provenzano, Anthony A	DOIID	1055736	NAIC NPN	17526220

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	2/24/2021		5/31/2026
* 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
Denied	Brighthouse Life Insurance Company	301829	Agent - Life
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	11/22/2019	4/27/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Policygenius LLC	874468	Agent - Life