DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Polk, David	DOIID	578632	NAIC NPN	972784

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	10/16/2003		10/31/2026
Active	Non Resident	Agent	Life	10/16/2003		10/31/2026
* 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	Anthem Life Insurance Company	301209	Agent - Health	1/30/2009	11/2/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	1/30/2009	11/2/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/1/2016	12/19/2019
Inactive	Nassau Life Insurance Company	301406	Agent - Life	1/8/2004	5/10/2006
Active	Northwestern Mutual Life Insurance Company	300931	Agent - Health	10/17/2003
Active	Northwestern Mutual Life Insurance Company	300931	Agent - Life	10/17/2003
Inactive	PHL Variable Insurance Company	300525	Agent - Life	1/8/2004	5/10/2006
Inactive	Pruco Life Insurance Company	300954	Agent - Health	12/29/2003	12/23/2014
Inactive	Pruco Life Insurance Company	300954	Agent - Life	12/29/2003	12/23/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	1/30/2009	11/2/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Health	1/30/2009	11/2/2016
Inactive	Medlink Inc	400721	Agent - Life	2/23/2009	3/31/2024
Inactive	Medlink Inc	400721	Agent - Health	2/23/2009	3/31/2024