DEPARTMENT OF INSURANCE
Affiliations
NameFuller Jr, David ADOIID390618NAIC NPN759367
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentHealth10/18/1996 4/30/2025
ActiveNon ResidentAgentLife10/18/1996 4/30/2025
ActiveNon ResidentAgentVariable Life and Variable Annuities5/31/2001 4/30/2025
InactiveNon ResidentAgentHealth Maintenance Organization9/23/19993/1/2001 
* 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 - Health6/24/200310/20/2011
InactiveAmerican General Life Insurance Company301585Agent - Life6/24/200310/20/2011
InactiveAmerican General Life Insurance Company301585Agent - Variable Life and Variable Annuities6/24/20031/14/2022
InactiveAmerican Heritage Life Insurance Company300272Agent - Health11/7/20121/23/2013
InactiveAmerican Heritage Life Insurance Company300272Agent - Life11/7/20121/23/2013
ActiveAmerican United Life Insurance Company300498Agent - Health12/13/1999 
ActiveAmerican United Life Insurance Company300498Agent - Life12/13/1999 
InactiveAthene Annuity & Life Assurance Company301798Agent - Health4/11/20078/3/2010
InactiveAthene Annuity & Life Assurance Company301798Agent - Life4/11/20078/3/2010
ActiveBanner Life Insurance Company301696Agent - Life7/6/2016 
InactiveBerkshire Life Insurance Company of America300983Agent - Health1/22/20049/16/2013
InactiveBerkshire Life Insurance Company of America300983Agent - Life1/22/20049/16/2013
InactiveC.M. Life Insurance Company301335Agent - Health10/21/19993/18/2009
InactiveC.M. Life Insurance Company301335Agent - Life10/21/19993/18/2009
InactiveC.M. Life Insurance Company301335Agent - Variable Life and Variable Annuities5/28/20023/18/2009
ActiveCIGNA Health & Life Insurance Company301783Agent - Health12/21/2023 
InactiveClarica Life Insurance Company - U.S.300207Agent - Life5/16/20024/26/2004
InactiveCompBenefits Dental, Inc.591692Agent - Health3/25/201412/5/2014
InactiveCompBenefits Insurance Company301864Agent - Health6/25/202012/15/2020
InactiveCompBenefits Insurance Company301864Agent - Life5/7/201012/5/2011
InactiveDental Concern Inc. (The)301641Agent - Health5/13/202012/15/2020
InactiveEquitable Financial Life Insurance Company300808Agent - Life4/24/200812/10/2010
InactiveEquitable Financial Life Insurance Company300808Agent - Variable Life and Variable Annuities4/24/200812/10/2010
InactiveFirst Colony Life Insurance Company301179Agent - Life7/16/20011/1/2007
InactiveGenworth Life and Annuity Insurance Company301276Agent - Health4/24/200912/7/2012
InactiveGenworth Life and Annuity Insurance Company301276Agent - Life1/1/200712/7/2012
ActiveGuardian Life Insurance Company of America301316Agent - Health1/22/2004 
ActiveGuardian Life Insurance Company of America301316Agent - Life1/22/2004 
ActiveHartford Life and Accident Insurance Company300878Agent - Health3/5/2007 
ActiveHartford Life and Accident Insurance Company300878Agent - Life3/5/2007 
InactiveHumana Benefit Plan of Illinois, Inc.781543Agent - Health6/25/202012/15/2020
InactiveHumana Health Plan of Ohio Inc.301565Agent - Health6/25/202012/15/2020
ActiveHumana Health Plan, Inc.300142Agent - Health5/13/2020 
InactiveHumana Health Plan, Inc.300142Agent - Health Maintenance Organization9/23/19993/1/2001
ActiveHumana Insurance Company301104Agent - Health11/8/2021 
InactiveHumana Insurance Company301104Agent - Life12/17/201812/19/2019
InactiveHumana Insurance Company of Kentucky300826Agent - Health4/14/20174/8/2020
InactiveHumana Insurance Company of Kentucky300826Agent - Life5/13/202012/15/2020
InactiveHumana Medical Plan, Inc.801568Agent - Health6/25/202012/15/2020
InactiveHumana Wisconsin Health Organization Insurance Corporation830687Agent - Health6/25/202012/15/2020
InactiveHumanaDental Insurance Company301457Agent - Health6/3/20022/24/2012
InactiveIllinois Mutual Life Insurance Company301479Agent - Health1/10/19976/17/1999
InactiveIllinois Mutual Life Insurance Company301479Agent - Life1/10/19976/17/1999
InactiveJohn Alden Life Insurance Company300573Agent - Health8/28/20006/3/2002
InactiveJohn Alden Life Insurance Company300573Agent - Life8/28/20006/3/2002
InactiveKanawha Insurance Company300127Agent - Health3/25/201412/5/2014
InactiveKanawha Insurance Company300127Agent - Life3/25/201412/5/2014
ActiveLife Insurance Company of North America300711Agent - Health1/14/2019 
ActiveLife Insurance Company of North America300711Agent - Life9/29/2014 
ActiveLife Insurance Company of North America300711Agent - Variable Life and Variable Annuities6/17/2021 
InactiveLincoln Benefit Life Company301110Agent - Health5/16/20067/14/2014
InactiveLincoln Benefit Life Company301110Agent - Life5/16/20067/14/2014
InactiveLincoln Benefit Life Company301110Agent - Variable Life and Variable Annuities5/16/20067/14/2014
ActiveLincoln National Life Insurance Company (The)301382Agent - Health6/29/2007 
ActiveLincoln National Life Insurance Company (The)301382Agent - Life6/29/2007 
InactiveLincoln National Life Insurance Company (The)301382Agent - Variable Life and Variable Annuities6/29/20076/12/2015
InactiveMML Bay State Life Insurance Company301198Agent - Health10/21/19995/28/2002
InactiveMML Bay State Life Insurance Company301198Agent - Life10/21/19995/28/2002
InactiveMassachusetts Mutual Life Insurance Company300445Agent - Health10/21/19993/18/2009
InactiveMassachusetts Mutual Life Insurance Company300445Agent - Life10/21/19993/18/2009
InactiveMassachusetts Mutual Life Insurance Company300445Agent - Variable Life and Variable Annuities5/31/20013/18/2009
InactiveMidland National Life Insurance Company300923Agent - Life4/26/20043/9/2005
InactiveNorthwestern Mutual Life Insurance Company300931Agent - Health10/18/19962/8/1999
InactiveNorthwestern Mutual Life Insurance Company300931Agent - Life10/18/19962/8/1999
InactivePartnerRe Life Reinsurance Company of America300550Agent - Health4/25/200211/7/2011
InactivePaul Revere Life Insurance Company300971Agent - Health11/21/19966/17/1999
InactivePaul Revere Life Insurance Company300971Agent - Life11/21/19966/17/1999
ActivePrincipal Life Insurance Company300129Agent - Health12/4/1999 
ActivePrincipal Life Insurance Company300129Agent - Life12/4/1999 
InactivePrincipal Life Insurance Company300129Agent - Variable Life and Variable Annuities5/31/20013/25/2011
InactiveProvident Life and Accident Insurance Company301525Agent - Health6/18/20109/9/2015
InactiveProvident Life and Accident Insurance Company301525Agent - Life6/18/20109/9/2015
InactiveReassure America Life Insurance Company301902Agent - Health3/20/20009/3/2004
InactiveReassure America Life Insurance Company301902Agent - Life3/20/20009/3/2004
ActiveSun Life Assurance Company of Canada301811Agent - Health5/1/2020 
ActiveSun Life Assurance Company of Canada301811Agent - Life5/1/2020 
ActiveSuperior Dental Care Inc.300418Agent - Health1/28/2011 
ActiveSymetra Life Insurance Company301691Agent - Health10/29/2018 
ActiveSymetra Life Insurance Company301691Agent - Life10/29/2018 
ActiveSymetra Life Insurance Company301691Agent - Variable Life and Variable Annuities10/29/2018 
InactiveUNUM Life Insurance Company of America300817Agent - Health6/18/20109/9/2015
InactiveUNUM Life Insurance Company of America300817Agent - Life6/18/20109/9/2015
InactiveUnion Security Insurance Company301844Agent - Health6/24/200212/19/2012
InactiveUnion Security Insurance Company301844Agent - Life6/24/200212/19/2012
InactiveUnited Heartland Life Insurance Company517547Agent - Health12/27/20017/31/2006
InactiveUnited Heartland Life Insurance Company517547Agent - Life12/27/20017/31/2006
InactiveUnited Wisconsin Insurance Company301103Agent - Health12/27/20017/31/2006
ActiveUnited of Omaha Life Insurance Company300156Agent - Health11/18/2002 
ActiveUnited of Omaha Life Insurance Company300156Agent - Life11/18/2002 
ActiveUnited of Omaha Life Insurance Company300156Agent - Variable Life and Variable Annuities3/7/2024 
InactiveUnitedHealthcare Insurance Company300946Agent - Health11/20/201211/30/2016
InactiveUnitedHealthcare Insurance Company300946Agent - Life11/20/201211/30/2016
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health11/20/201211/30/2016
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health11/20/201211/30/2016
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveAssuredpartners Nl, Llc762387Agent - Life9/21/2011 
ActiveAssuredpartners Nl, Llc762387Agent - Health9/21/2011 
InactiveAssuredpartners Nl, Llc762387Agent - Variable Life and Variable Annuities9/21/201110/16/2011
InactiveDental Choice Agency Inc.398085Agent - Health4/13/20097/21/2014
ActiveDesignated Agent Company Inc.681257Agent - Life12/6/2013 
ActiveDesignated Agent Company Inc.681257Agent - Health12/6/2013 
InactiveNeace & Associates Insurance Agency of OH, Inc.521908Agent - Life2/11/20053/31/2013
InactiveNeace & Associates Insurance Agency of OH, Inc.521908Agent - Health2/11/20053/31/2013

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