DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, David O'Brien	DOIID	564049	NAIC NPN	7039536

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	2/24/2003	10/31/2007
Inactive	Non Resident	Agent	Health	2/24/2003	10/31/2007
* 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	Metropolitan Life Insurance Company	301948	Agent - Health	10/6/2003	10/31/2007
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	10/6/2003	10/31/2007
Inactive	Pennsylvania Manufacturers Association Insurance Company	300228	Agent - Health	3/12/2003	10/31/2007
Inactive	Principal Life Insurance Company	300129	Agent - Health	2/24/2003	10/31/2007
Inactive	Principal Life Insurance Company	300129	Agent - Life	2/24/2003	10/31/2007

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Palmer & Cay of Georgia, LLC	549844	Agent - Health	2/9/2004	1/1/2006
Inactive	Palmer & Cay of Georgia, LLC	549844	Agent - Life	2/9/2004	1/1/2006
Inactive	USI Insurance Services National, Inc	509421	Agent - Health	1/4/2006	1/24/2007
Inactive	USI Insurance Services National, Inc	509421	Agent - Life	1/4/2006	1/24/2007