DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Hellickson, Mark Allan	DOIID	719657	NAIC NPN	351879

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	8/17/2023		7/31/2026
Active	Non Resident	Agent	Health	8/17/2023		7/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	05/15/2026	07/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Pruco Life Insurance Company	300954	Agent - Life	12/21/2009	3/16/2010
Inactive	Prudential Insurance Company of America	300784	Agent - Life	12/21/2009	3/16/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Pending	Crc Insurance Services, LLC	502276	Agent - Life
Pending	Crc Insurance Services, LLC	502276	Agent - Health