DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Bourgoin, David	DOIID	1245310	NAIC NPN	20427987

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	12/5/2022		9/30/2026
Active	Non Resident	Agent	Life	12/5/2022		9/30/2026
* 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	07/15/2024	09/30/2024	09/06/2024	09/06/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Freedom Life Insurance Company of America	300074	Agent - Health	12/7/2022
Active	Freedom Life Insurance Company of America	300074	Agent - Life	12/7/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Ushealth Advisors Llc	713288	Agent - Life	12/7/2022
Active	Ushealth Advisors Llc	713288	Agent - Health	12/7/2022