DEPARTMENT OF INSURANCE
Affiliations
NameEBC IncDOIID518231NAIC NPN1927215
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentHealth12/5/20005/20/2010 
InactiveNon ResidentAgentLife12/5/20005/20/2010 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveProvident Life and Accident Insurance Company301525Agent - Health9/22/200612/30/2009
InactiveProvident Life and Accident Insurance Company301525Agent - Life9/22/200612/30/2009
InactiveSymetra Life Insurance Company301691Agent - Health12/5/20005/20/2010
InactiveSymetra Life Insurance Company301691Agent - Life12/5/20005/20/2010
InactiveUNUM Life Insurance Company of America300817Agent - Health9/22/200612/30/2009
InactiveUNUM Life Insurance Company of America300817Agent - Life9/22/200612/30/2009
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveDust, Larry R. 359389Agent - Health3/3/20085/20/2010
InactiveDust, Larry R. 359389Agent - Life3/3/20085/20/2010
InactivePerna, Michael Domenic 510129Agent - Health12/5/20003/3/2008
InactivePerna, Michael Domenic 510129Agent - Life12/5/20003/3/2008

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