DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Domitz, Dustin Dean	DOIID	1171770	NAIC NPN	20137538

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Limited Line Credit	11/18/2021		2/28/2026
Active	Resident	Agent	Life	4/27/2023		2/28/2026
Active	Resident	Agent	Health	5/31/2023		2/28/2026
* 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
Active	American Health and Life Insurance Company	300844	Agent - Health	6/1/2023
Active	American Health and Life Insurance Company	300844	Agent - Life	4/28/2023
Active	American Health and Life Insurance Company	300844	Agent - Limited Line Credit	1/11/2022
Active	Triton Insurance Company	300654	Agent - Limited Line Credit	1/11/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Onemain Assurance Services LLC	751094	Agent - Limited Line Credit	1/11/2022
Active	Onemain Assurance Services LLC	751094	Agent - Health	6/1/2023
Active	Onemain Assurance Services LLC	751094	Agent - Life	4/28/2023