DEPARTMENT OF INSURANCE

Affiliations

Name	Long, David	DOIID	729099	NAIC NPN	15785916

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	8/6/2010	1/1/2013
* 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
Denied	Fifth Third Insurance Agency Inc	399341	Agent - Life