DEPARTMENT OF INSURANCE
Affiliations
NameShively, Andrew BlakeDOIID662373NAIC NPN9605159
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveResidentAgentHealth8/21/201411/1/2017 
InactiveResidentAgentVariable Life and Variable Annuities3/23/201511/1/2017 
InactiveResidentAgentCasualty7/7/201511/1/2017 
InactiveResidentAgentProperty7/7/201511/1/2017 
InactiveResidentAgentLife4/8/201411/1/2017 
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAnthem Life Insurance Company301209Agent - Health4/20/201511/3/2016
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Health4/7/20151/21/2017
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Life4/7/20151/21/2017
InactiveNationwide Assurance Company300166Agent - Casualty7/15/201512/6/2017
InactiveNationwide General Insurance Company300603Agent - Casualty7/15/201512/6/2017
InactiveNationwide General Insurance Company300603Agent - Property7/15/201512/6/2017
InactiveNationwide Insurance Company of America300333Agent - Casualty7/15/201512/6/2017
InactiveNationwide Insurance Company of America300333Agent - Property7/15/201512/6/2017
InactiveNationwide Life Insurance Company300495Agent - Health8/25/201412/6/2017
InactiveNationwide Life Insurance Company300495Agent - Life4/9/201412/6/2017
InactiveNationwide Life Insurance Company300495Agent - Variable Life and Variable Annuities3/27/20159/1/2016
InactiveNationwide Life and Annuity Insurance Company300714Agent - Health8/25/201412/6/2017
InactiveNationwide Life and Annuity Insurance Company300714Agent - Life4/9/201412/6/2017
InactiveNationwide Life and Annuity Insurance Company300714Agent - Variable Life and Variable Annuities3/27/20159/1/2016
InactiveNationwide Mutual Fire Insurance Company301722Agent - Casualty7/15/201512/6/2017
InactiveNationwide Mutual Fire Insurance Company301722Agent - Property7/15/201512/6/2017
InactiveNationwide Mutual Insurance Company301749Agent - Casualty7/15/201512/6/2017
InactiveNationwide Mutual Insurance Company301749Agent - Property7/15/201512/6/2017
InactiveNationwide Property and Casualty Insurance Company300599Agent - Casualty7/15/201512/6/2017
InactiveNationwide Property and Casualty Insurance Company300599Agent - Property7/15/201512/6/2017
InactiveNorthwestern Long Term Care Insurance Company300135Agent - Health9/1/200911/1/2009
InactiveNorthwestern Mutual Life Insurance Company300931Agent - Health10/19/200711/1/2009
InactiveNorthwestern Mutual Life Insurance Company300931Agent - Life11/9/200711/1/2009
InactiveVictoria Fire & Casualty Company300313Agent - Casualty7/15/201512/6/2017
InactiveVictoria Fire & Casualty Company300313Agent - Property7/15/201512/6/2017
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveD2 Enterprises LLC817210Agent - Life6/23/201411/1/2017
InactiveD2 Enterprises LLC817210Agent - Health8/25/201411/1/2017
InactiveDesignated Agent Company Inc.681257Agent - Life4/20/201511/2/2016
InactiveDesignated Agent Company Inc.681257Agent - Health4/20/201511/2/2016

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