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DEPARTMENT OF INSURANCE
Affiliations
Name
EBC Inc
DOIID
518231
NAIC NPN
1927215
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Inactive
Non Resident
Agent
Health
12/5/2000
5/20/2010
Inactive
Non Resident
Agent
Life
12/5/2000
5/20/2010
* 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
Inactive
Provident Life and Accident Insurance Company
301525
Agent - Health
9/22/2006
12/30/2009
Inactive
Provident Life and Accident Insurance Company
301525
Agent - Life
9/22/2006
12/30/2009
Inactive
Symetra Life Insurance Company
301691
Agent - Health
12/5/2000
5/20/2010
Inactive
Symetra Life Insurance Company
301691
Agent - Life
12/5/2000
5/20/2010
Inactive
UNUM Life Insurance Company of America
300817
Agent - Health
9/22/2006
12/30/2009
Inactive
UNUM Life Insurance Company of America
300817
Agent - Life
9/22/2006
12/30/2009
Designated Individuals
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Dust, Larry R.
359389
Agent - Health
3/3/2008
5/20/2010
Inactive
Dust, Larry R.
359389
Agent - Life
3/3/2008
5/20/2010
Inactive
Perna, Michael Domenic
510129
Agent - Health
12/5/2000
3/3/2008
Inactive
Perna, Michael Domenic
510129
Agent - Life
12/5/2000
3/3/2008
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