DEPARTMENT OF INSURANCE
Affiliations
NameGustafson, Gary DDOIID650803NAIC NPN7745468
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentLife3/7/20079/30/2014 
InactiveNon ResidentAgentHealth3/7/20079/30/2014 
* 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
InactiveFidelity Investments Life Insurance Company300620Agent - Health9/25/200810/2/2012
InactiveFidelity Investments Life Insurance Company300620Agent - Life9/25/200810/2/2012
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveFidelity Employer Ins Services Inc653192Agent - Life10/6/200910/2/2012
InactiveFidelity Employer Ins Services Inc653192Agent - Health10/6/200910/2/2012
InactiveFidelity Insurance Agency Inc.400221Agent - Life4/8/201110/2/2012
InactiveFidelity Insurance Agency Inc.400221Agent - Health4/8/201110/2/2012

© Commonwealth of Kentucky. All rights reserved.