DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Dobrzykowski, David D	DOIID	606214	NAIC NPN	8047746

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	4/4/2005	7/31/2008
Inactive	Non Resident	Agent	Health	4/4/2005	7/31/2008
* 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	Aetna Health Inc.	300694	Agent - Health	5/16/2005	12/31/2007
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	12/31/2007	7/31/2008
Inactive	Aetna Life Insurance Company	301140	Agent - Health	5/16/2005	7/31/2008
Inactive	Aetna Life Insurance Company	301140	Agent - Life	5/16/2005	7/31/2008
Inactive	Anthem Life Insurance Company	301209	Agent - Health	5/1/2005	7/31/2008
Inactive	Anthem Life Insurance Company	301209	Agent - Life	5/1/2005	7/31/2008
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	6/23/2005	7/31/2008
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	6/23/2005	7/31/2008
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	6/23/2005	7/31/2008
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	6/23/2005	7/31/2008
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	6/29/2007	7/31/2008
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	6/29/2007	7/31/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	5/19/2005	6/21/2008
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	5/19/2005	6/21/2008
Inactive	Corporate One Benefits Agcy Inc	607836	Agent - Life	6/27/2005	1/18/2007
Inactive	Corporate One Benefits Agcy Inc	607836	Agent - Health	6/27/2005	1/18/2007
Inactive	Designated Agent Company Inc.	681257	Agent - Life	6/28/2008	7/31/2008
Inactive	Designated Agent Company Inc.	681257	Agent - Health	6/28/2008	7/31/2008