DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Dausman, David Robert	DOIID	566327	NAIC NPN	6399016

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	3/14/2003	8/31/2024
* 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	Hartford Life and Accident Insurance Company	300878	Agent - Health	7/21/2016	9/30/2017
Inactive	QBE Insurance Corporation	300515	Agent - Health	3/26/2003	10/9/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Excess Risk Reinsurance, Inc.	567406	Agent - Health	4/7/2003	3/31/2021
Inactive	Reunion Health Services, LLC	1148948	Agent - Health	8/4/2021	8/31/2024
Denied	Starr Wright Insurance Agency , Inc	397651	Agent - Health