DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Goldberg, Mark Harvey	DOIID	667441	NAIC NPN	1191842

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	6/9/2015	4/30/2017
Inactive	Non Resident	Agent	Health	6/9/2015	4/30/2017
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	ACSIA Partners LLC	784413	Agent - Health	6/19/2012	3/1/2013
Inactive	ACSIA Partners LLC	784413	Agent - Life	6/19/2012	3/1/2013
Inactive	Senior Commission Funding LLC	777300	Agent - Health	3/1/2013	4/30/2013
Inactive	Senior Commission Funding LLC	777300	Agent - Life	3/1/2013	4/30/2013