DEPARTMENT OF INSURANCE
Affiliations
NameBlaske, Mark DouglasDOIID325482NAIC NPN712829
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveResidentAgentVariable Life and Variable Annuities9/27/20027/1/2004 
InactiveResidentAgentLife9/27/20027/1/2004 
InactiveResidentAgentHealth9/27/20027/1/2004 
* 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
InactiveAllianz Life Insurance Company of North America301791Agent - Health1/24/20037/1/2004
InactiveAllianz Life Insurance Company of North America301791Agent - Life1/24/20037/1/2004
InactiveContinental Casualty Company301019Agent - Health9/16/199812/30/1999
InactiveEquitable Financial Life Insurance Company300808Agent - Health7/12/20017/1/2002
InactiveEquitable Financial Life Insurance Company300808Agent - Life11/21/19967/1/2002
InactiveEquitable Financial Life Insurance Company300808Agent - Variable Life and Variable Annuities3/19/20017/1/2002
InactiveEquitable Financial Life Insurance Company of America301772Agent - Health12/18/20022/20/2004
InactiveEquitable Financial Life Insurance Company of America301772Agent - Life12/18/20022/20/2004
InactiveEquitable Financial Life Insurance Company of America301772Agent - Variable Life and Variable Annuities12/18/20022/20/2004
InactiveEquitable Financial Life and Annuity Company301833Agent - Life12/30/19967/1/2002
InactiveFirst Colony Life Insurance Company301179Agent - Health1/23/20037/1/2004
InactiveFirst Colony Life Insurance Company301179Agent - Life1/23/20037/1/2004
InactiveFirst Colony Life Insurance Company301179Agent - Variable Life and Variable Annuities1/23/20037/1/2004
InactiveFortitude Life Insurance & Annuity Company301503Agent - Life4/9/20037/1/2004
InactiveFortitude Life Insurance & Annuity Company301503Agent - Variable Life and Variable Annuities4/9/20037/1/2004
InactiveMONY Life Insurance Company301141Agent - Health12/18/20022/20/2004
InactiveMONY Life Insurance Company301141Agent - Life12/18/20022/20/2004
InactiveMONY Life Insurance Company301141Agent - Variable Life and Variable Annuities12/18/20022/20/2004
InactivePaul Revere Life Insurance Company300971Agent - Health2/13/19988/24/2000
InactivePaul Revere Life Insurance Company300971Agent - Life2/13/19988/24/2000
InactivePrincipal Life Insurance Company300129Agent - Health1/17/20037/1/2004
InactivePrincipal Life Insurance Company300129Agent - Life1/17/20037/1/2004
InactiveProvident Life and Accident Insurance Company301525Agent - Health2/13/19987/1/2002
InactiveProvident Life and Accident Insurance Company301525Agent - Life2/13/19987/1/2002
InactiveReassure America Life Insurance Company301902Agent - Health6/12/19977/1/2002
InactiveReassure America Life Insurance Company301902Agent - Life6/12/19977/1/2002
InactiveWest Coast Life Insurance Company301607Agent - Health6/11/19977/1/2002
InactiveWest Coast Life Insurance Company301607Agent - Life6/11/19977/1/2002
InactiveWestern and Southern Life Insurance Company301744Agent - Health9/27/20021/10/2003
InactiveWestern and Southern Life Insurance Company301744Agent - Life9/27/20021/10/2003
InactiveWestern-Southern Life Assurance Company301590Agent - Health9/27/20021/10/2003
InactiveWestern-Southern Life Assurance Company301590Agent - Life9/27/20021/10/2003
Inactive300277Agent - Life1/21/20037/1/2004
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveMedlink Inc400721Agent - Health2/12/20047/1/2004
InactiveMedlink Inc400721Agent - Life2/12/20047/1/2004

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