PUBLIC PROTECTION
CABINET
DEPARTMENT OF INSURANCE
Affiliations
NameDorman, Mark JDOIID644735NAIC NPN2262876
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentHealth11/21/200611/30/2018 
InactiveNon ResidentAgentLife11/21/200611/30/2018 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveC.M. Life Insurance Company301335Agent - Health12/11/200611/30/2018
InactiveC.M. Life Insurance Company301335Agent - Life12/11/200611/30/2018
InactiveMassachusetts Mutual Life Insurance Company300445Agent - Health12/11/200611/30/2018
InactiveMassachusetts Mutual Life Insurance Company300445Agent - Life12/11/200611/30/2018
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveDS Benefits Group, LLC772207Agent - Life1/10/20123/11/2014
InactiveDS Benefits Group, LLC772207Agent - Health1/10/20123/11/2014

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