DEPARTMENT OF INSURANCE
Affiliations
NameDouglas, Keith JDOIID320113NAIC NPN697938
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentVariable Life and Variable Annuities5/31/2001 2/28/2026
ActiveNon ResidentAgentHealth4/16/2001 2/28/2026
ActiveNon ResidentAgentLife6/7/2001 2/28/2026
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAmerican General Life Insurance Company301585Agent - Health4/1/200710/25/2012
InactiveAmerican General Life Insurance Company301585Agent - Life4/1/200710/25/2012
InactiveAmerican General Life Insurance Company301585Agent - Variable Life and Variable Annuities4/1/200710/25/2012
InactiveBrighthouse Life Insurance Company301829Agent - Health11/16/19992/14/2001
InactiveBrighthouse Life Insurance Company301829Agent - Life5/29/200112/15/2003
InactiveCommonwealth Annuity and Life Insurance Company300798Agent - Life6/28/20013/6/2013
InactiveCommonwealth Annuity and Life Insurance Company300798Agent - Variable Life and Variable Annuities6/28/20013/6/2013
InactiveDelaware Life Insurance Company301256Agent - Life5/21/20013/20/2003
InactiveDelaware Life Insurance Company301256Agent - Variable Life and Variable Annuities12/31/200311/30/2006
InactiveEverlake Life Insurance Company300873Agent - Life5/18/200512/3/2008
InactiveEverlake Life Insurance Company300873Agent - Variable Life and Variable Annuities5/18/200512/3/2008
InactiveFirst Colony Life Insurance Company301179Agent - Health5/21/20011/1/2007
InactiveFirst Colony Life Insurance Company301179Agent - Life6/7/20011/1/2007
InactiveFirst Penn-Pacific Life Insurance Company301581Agent - Health10/25/20002/14/2001
InactiveFirst Penn-Pacific Life Insurance Company301581Agent - Life10/25/20002/14/2001
InactiveGenworth Life and Annuity Insurance Company301276Agent - Health1/1/20075/22/2009
InactiveGenworth Life and Annuity Insurance Company301276Agent - Life1/1/20075/22/2009
InactiveGlenbrook Life and Annuity Company301384Agent - Life2/6/20041/1/2005
InactiveGlenbrook Life and Annuity Company301384Agent - Variable Life and Variable Annuities2/6/20041/1/2005
ActiveJackson National Life Insurance Company300486Agent - Variable Life and Variable Annuities12/22/2008 
InactiveJohn Hancock Life Insurance Company300821Agent - Health6/6/200112/8/2006
InactiveJohn Hancock Life Insurance Company300821Agent - Life6/7/200112/8/2006
InactiveJohn Hancock Life Insurance Company300821Agent - Variable Life and Variable Annuities6/6/200112/20/2006
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Health11/2/20002/14/2001
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Life11/2/20002/14/2001
InactiveJohn Hancock Variable Life Insurance Company301914Agent - Health6/6/200112/1/2005
InactiveJohn Hancock Variable Life Insurance Company301914Agent - Life6/7/200112/1/2005
InactiveJohn Hancock Variable Life Insurance Company301914Agent - Variable Life and Variable Annuities6/6/200112/1/2005
InactiveKeyport Life Insurance Company300319Agent - Life10/8/19992/14/2001
InactiveKeyport Life Insurance Company300319Agent - Variable Life and Variable Annuities5/29/200112/31/2003
InactiveLincoln Life Assurance Company of Boston301915Agent - Life6/25/201010/10/2019
InactiveLincoln National Life Insurance Company (The)301382Agent - Life12/8/200812/1/2016
InactiveLincoln National Life Insurance Company (The)301382Agent - Variable Life and Variable Annuities12/8/200812/1/2016
InactiveManufacturers Life Insurance Company of America (The)300618Agent - Life11/2/20002/14/2001
InactiveMetLife Life and Annuity Company of Connecticut301593Agent - Health11/16/19992/14/2001
InactiveMetLife Life and Annuity Company of Connecticut301593Agent - Life6/7/20014/29/2005
InactiveNationwide Life Insurance Company300495Agent - Health1/24/20002/14/2001
InactiveNationwide Life Insurance Company300495Agent - Life1/24/20002/14/2001
InactiveNationwide Life Insurance Company300495Agent - Variable Life and Variable Annuities5/31/20016/2/2005
InactiveNationwide Life and Annuity Insurance Company300714Agent - Life6/7/20016/2/2005
InactiveNationwide Life and Annuity Insurance Company300714Agent - Variable Life and Variable Annuities5/31/20016/2/2005
ActiveNew York Life Insurance and Annuity Corporation300726Agent - Life12/15/2008 
ActiveNew York Life Insurance and Annuity Corporation300726Agent - Variable Life and Variable Annuities12/15/2008 
InactiveNorthbrook Life Insurance Company301020Agent - Life10/4/19992/14/2001
InactiveNorthbrook Life Insurance Company301020Agent - Variable Life and Variable Annuities4/30/20011/1/2003
InactivePacific Life Insurance Company301848Agent - Life8/18/20069/23/2015
InactivePacific Life Insurance Company301848Agent - Variable Life and Variable Annuities8/18/20069/23/2015
InactiveProtective Life Insurance Company300638Agent - Health5/11/202311/23/2023
InactiveProtective Life Insurance Company300638Agent - Life5/11/202311/23/2023
InactiveProtective Life Insurance Company300638Agent - Variable Life and Variable Annuities5/11/202311/23/2023
InactiveProvident Life and Accident Insurance Company301525Agent - Health1/14/20002/14/2001
InactiveProvident Life and Accident Insurance Company301525Agent - Life1/14/20002/14/2001
InactiveStandard Insurance Company300185Agent - Health10/29/201812/5/2022
InactiveStandard Insurance Company300185Agent - Life10/29/201812/5/2022
InactiveStandard Insurance Company300185Agent - Variable Life and Variable Annuities10/29/201812/5/2022
ActiveState Life Insurance Company301497Agent - Health11/26/2019 
ActiveState Life Insurance Company301497Agent - Life11/26/2019 
InactiveSunAmerica Annuity and Life Assurance Company301930Agent - Health11/1/20002/14/2001
InactiveSunAmerica Annuity and Life Assurance Company301930Agent - Life11/1/20002/14/2001
InactiveTalcott Resolution Life Insurance Company301759Agent - Health4/16/20016/13/2005
InactiveTalcott Resolution Life Insurance Company301759Agent - Life6/7/20016/13/2005
InactiveTalcott Resolution Life Insurance Company301759Agent - Variable Life and Variable Annuities5/31/20016/13/2005
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Health4/16/20016/13/2005
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Life6/7/20016/13/2005
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Variable Life and Variable Annuities5/31/20016/13/2005
InactiveUNUM Life Insurance Company of America300817Agent - Health3/2/20002/14/2001
InactiveUNUM Life Insurance Company of America300817Agent - Life3/2/20002/14/2001
InactiveVenerable Insurance and Annuity Company301006Agent - Life9/4/20039/3/2008
InactiveVenerable Insurance and Annuity Company301006Agent - Variable Life and Variable Annuities9/4/20039/3/2008
InactiveWestern National Life Insurance Company300461Agent - Life10/15/200312/24/2008
InactiveWestern Reserve Life Assurance Company of Ohio300760Agent - Health2/26/20035/23/2003
InactiveWestern Reserve Life Assurance Company of Ohio300760Agent - Life2/26/20035/23/2003
InactiveWestern Reserve Life Assurance Company of Ohio300760Agent - Variable Life and Variable Annuities12/13/20025/23/2003
InactiveWestern and Southern Life Insurance Company301744Agent - Health1/21/200910/28/2011
InactiveWestern and Southern Life Insurance Company301744Agent - Life1/21/200910/28/2011
ActiveWestern-Southern Life Assurance Company301590Agent - Health12/12/2008 
ActiveWestern-Southern Life Assurance Company301590Agent - Life12/12/2008 
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveFifth Third Insurance Agency Inc399341Agent - Life2/11/2009 
ActiveFifth Third Insurance Agency Inc399341Agent - Health2/11/2009 
ActiveFifth Third Insurance Agency Inc399341Agent - Variable Life and Variable Annuities2/11/2009 

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