DEPARTMENT OF INSURANCE

Affiliations

Name	Medick, David Michael	DOIID	1268587	NAIC NPN	6051773

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	4/13/2023	6/30/2025
Active	Non Resident	Agent	Variable Life and Variable Annuities	4/13/2023	6/30/2025
Active	Non Resident	Agent	Health	4/13/2023	6/30/2025
* 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.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Allianz Life Insurance Company of North America	301791	Agent - Life	5/8/2023
Active	Allianz Life Insurance Company of North America	301791	Agent - Variable Life and Variable Annuities	5/8/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Ameriprise Financial Services, LLC	398326	Agent - Life	7/14/2023
Denied	Ameriprise Financial Services, LLC	398326	Agent - Health
Active	Ameriprise Financial Services, LLC	398326	Agent - Variable Life and Variable Annuities	7/14/2023