DEPARTMENT OF INSURANCE
Affiliations
NameSiegman, Mark DOIID1191903NAIC NPN1029595
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
Pending ReplacementNon ResidentAgentHealth3/7/2022 6/30/2024
Pending ReplacementNon ResidentAgentVariable Life and Variable Annuities3/7/2022 6/30/2024
Pending ReplacementNon ResidentAgentLife3/7/2022 6/30/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent04/15/202406/30/2024   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
Pending ReplacementMassachusetts Mutual Life Insurance Company300445Agent - Life9/29/2022 
InactivePruco Life Insurance Company300954Agent - Health3/10/20227/6/2023
InactivePruco Life Insurance Company300954Agent - Life3/10/20227/6/2023
InactivePruco Life Insurance Company300954Agent - Variable Life and Variable Annuities3/10/20227/6/2023
InactivePrudential Insurance Company of America300784Agent - Health3/10/20227/6/2023
InactivePrudential Insurance Company of America300784Agent - Life3/10/20227/6/2023
InactivePrudential Insurance Company of America300784Agent - Variable Life and Variable Annuities3/10/20227/6/2023
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactivePrudential Insurance Agency LLC620187Agent - Health3/7/20237/6/2023
InactivePrudential Insurance Agency LLC620187Agent - Life3/7/20237/6/2023
InactivePrudential Insurance Agency LLC620187Agent - Variable Life and Variable Annuities3/7/20237/6/2023

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