DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Black, Doriana Rachel	DOIID	720774	NAIC NPN	7934140

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	1/7/2010	7/31/2016
Inactive	Non Resident	Agent	Property	1/7/2010	7/31/2016
* 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

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Permanent General Assurance Corporation of Ohio	709250	Agent - Casualty	1/8/2010	10/1/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	General Automobile Ins Services Inc	706632	Agent - Casualty	2/26/2014	10/1/2015