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DEPARTMENT OF INSURANCE
Affiliations
Name
Roth, David M
DOIID
539749
NAIC NPN
1473753
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Denied
Non Resident
Agent
Health
10/18/2001
2/28/2005
Inactive
Non Resident
Agent
Variable Life and Variable Annuities
10/22/2001
2/28/2005
Inactive
Non Resident
Agent
Life
10/18/2001
2/28/2005
* 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
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
C.M. Life Insurance Company
301335
Agent - Health
11/21/2001
10/15/2004
Inactive
C.M. Life Insurance Company
301335
Agent - Life
11/21/2001
10/15/2004
Inactive
C.M. Life Insurance Company
301335
Agent - Variable Life and Variable Annuities
11/21/2001
10/15/2004
Inactive
Everlake Life Insurance Company
300873
Agent - Life
1/1/2005
2/28/2005
Inactive
Everlake Life Insurance Company
300873
Agent - Variable Life and Variable Annuities
1/1/2005
2/28/2005
Inactive
Glenbrook Life and Annuity Company
301384
Agent - Life
11/19/2001
1/1/2005
Inactive
Glenbrook Life and Annuity Company
301384
Agent - Variable Life and Variable Annuities
11/19/2001
1/1/2005
Inactive
Jackson National Life Insurance Company
300486
Agent - Life
11/26/2001
10/6/2004
Inactive
Jackson National Life Insurance Company
300486
Agent - Variable Life and Variable Annuities
11/26/2001
10/6/2004
Inactive
MML Bay State Life Insurance Company
301198
Agent - Health
11/21/2001
10/16/2003
Inactive
MML Bay State Life Insurance Company
301198
Agent - Life
11/21/2001
10/16/2003
Inactive
MML Bay State Life Insurance Company
301198
Agent - Variable Life and Variable Annuities
11/21/2001
10/16/2003
Inactive
Massachusetts Mutual Life Insurance Company
300445
Agent - Health
11/21/2001
10/15/2004
Inactive
Massachusetts Mutual Life Insurance Company
300445
Agent - Life
11/21/2001
10/15/2004
Inactive
Massachusetts Mutual Life Insurance Company
300445
Agent - Variable Life and Variable Annuities
11/21/2001
10/15/2004
Inactive
Nationwide Life Insurance Company
300495
Agent - Health
12/17/2001
9/30/2004
Inactive
Nationwide Life Insurance Company
300495
Agent - Life
12/17/2001
9/30/2004
Inactive
Nationwide Life Insurance Company
300495
Agent - Variable Life and Variable Annuities
12/17/2001
9/30/2004
Denied
Nationwide Life and Annuity Insurance Company
300714
Agent - Health
Inactive
Nationwide Life and Annuity Insurance Company
300714
Agent - Life
12/17/2001
9/30/2004
Inactive
Nationwide Life and Annuity Insurance Company
300714
Agent - Variable Life and Variable Annuities
12/17/2001
9/30/2004
Inactive
Pacific Life Insurance Company
301848
Agent - Life
3/29/2002
2/28/2005
Inactive
Pacific Life Insurance Company
301848
Agent - Variable Life and Variable Annuities
3/29/2002
2/28/2005
Inactive
SunAmerica Annuity and Life Assurance Company
301930
Agent - Life
11/28/2001
2/28/2005
Inactive
SunAmerica Annuity and Life Assurance Company
301930
Agent - Variable Life and Variable Annuities
11/28/2001
2/28/2005
Inactive
Talcott Resolution Life Insurance Company
301759
Agent - Health
2/13/2002
11/24/2004
Inactive
Talcott Resolution Life Insurance Company
301759
Agent - Life
2/13/2002
11/24/2004
Inactive
Talcott Resolution Life Insurance Company
301759
Agent - Variable Life and Variable Annuities
2/13/2002
11/24/2004
Inactive
Talcott Resolution Life and Annuity Insurance Company
300932
Agent - Health
2/13/2002
11/24/2004
Inactive
Talcott Resolution Life and Annuity Insurance Company
300932
Agent - Life
2/13/2002
11/24/2004
Inactive
Talcott Resolution Life and Annuity Insurance Company
300932
Agent - Variable Life and Variable Annuities
2/13/2002
11/24/2004
Inactive
Western National Life Insurance Company
300461
Agent - Life
11/9/2001
11/4/2004
Inactive
Western-Southern Life Assurance Company
301590
Agent - Health
10/18/2001
9/30/2004
Inactive
Western-Southern Life Assurance Company
301590
Agent - Life
10/18/2001
9/30/2004
Inactive
Western-Southern Life Assurance Company
301590
Agent - Variable Life and Variable Annuities
10/22/2001
9/30/2004
Designated to act on behalf of the following Business Entities
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Fifth Third Insurance Agency Inc
399341
Agent - Life
4/27/2004
2/28/2005
Inactive
Fifth Third Insurance Agency Inc
399341
Agent - Variable Life and Variable Annuities
4/27/2004
2/28/2005
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