DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Small, Dustin	DOIID	1139660	NAIC NPN	19908507

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	10/15/2023		11/30/2024
Active	Non Resident	Agent	Life	10/15/2023		11/30/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	09/15/2024	11/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Accendo Insurance Company	300312	Agent - Life	6/24/2021	4/11/2022
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	6/24/2021	4/11/2022
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	8/30/2021	4/5/2022
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	6/24/2021	4/11/2022
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	6/24/2021	4/11/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Optavise, LLC	671337	Agent - Life
Denied	Optavise, LLC	671337	Agent - Health