DEPARTMENT OF INSURANCE

Affiliations

Name	Levy, Derek R	DOIID	1272778	NAIC NPN	5704855

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	5/4/2023		3/31/2026
* 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	Banner Life Insurance Company	301696	Agent - Life	5/15/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Sbhu Life Agency Inc	689591	Agent - Life	5/19/2023