DEPARTMENT OF INSURANCE

Affiliations

Name	Wiatr, David Michael	DOIID	766744	NAIC NPN	15659686

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Casualty	8/23/2013	4/30/2025
Active	Non Resident	Agent	Health	8/23/2013	4/30/2025
Active	Non Resident	Agent	Life	8/23/2013	4/30/2025
Active	Non Resident	Agent	Property	8/23/2013	4/30/2025
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	2/2/2012	4/30/2013
Inactive	Aetna Life Insurance Company	301140	Agent - Health	2/2/2012	4/30/2013
Active	Allmerica Financial Alliance Insurance Company	300823	Agent - Casualty	10/1/2018
Active	Allmerica Financial Alliance Insurance Company	300823	Agent - Property	10/1/2018
Active	Allmerica Financial Benefit Insurance Company	301223	Agent - Casualty	10/1/2018
Active	Allmerica Financial Benefit Insurance Company	301223	Agent - Property	10/1/2018
Active	AmGUARD Insurance Company	500010	Agent - Casualty	11/11/2019
Active	AmGUARD Insurance Company	500010	Agent - Property	11/11/2019
Active	American Builders Insurance Company	677578	Agent - Casualty	8/5/2021
Active	American Builders Insurance Company	677578	Agent - Property	8/5/2021
Active	American Contractors Indemnity Company	536843	Agent - Casualty	2/5/2019
Active	American Economy Insurance Company	300315	Agent - Casualty	3/31/2023
Active	American Economy Insurance Company	300315	Agent - Property	3/31/2023
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	3/13/2018	8/15/2018
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	3/13/2018	8/15/2018
Inactive	Anthem Life Insurance Company	301209	Agent - Health	3/2/2012	4/30/2013
Inactive	Anthem Life Insurance Company	301209	Agent - Life	3/2/2012	4/30/2013
Inactive	Auto-Owners Insurance Company	301480	Agent - Casualty	9/9/2014	9/4/2018
Inactive	Auto-Owners Insurance Company	301480	Agent - Property	9/9/2014	9/4/2018
Inactive	Banner Life Insurance Company	301696	Agent - Life	7/12/2012	4/30/2013
Active	Benchmark Insurance Company	300374	Agent - Casualty	7/1/2019
Active	Benchmark Insurance Company	300374	Agent - Property	7/1/2019
Active	BrickStreet Mutual Insurance Company	709251	Agent - Casualty	9/30/2020
Active	Bristol West Insurance Company	301655	Agent - Casualty	11/22/2019
Active	Bristol West Insurance Company	301655	Agent - Property	11/22/2019
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	6/16/2015	12/8/2015
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	6/16/2015	12/8/2015
Inactive	Encova Life Insurance Company	301818	Agent - Life	12/8/2021	1/1/2024
Inactive	Farmers Direct Property and Casualty Insurance Company	300957	Agent - Casualty	1/8/2021	12/29/2021
Inactive	Farmers Direct Property and Casualty Insurance Company	300957	Agent - Property	1/8/2021	12/29/2021
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	1/8/2021	4/26/2022
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Property	1/8/2021	4/26/2022
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	11/22/2019
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	11/22/2019
Inactive	Golden Rule Insurance Company	301943	Agent - Health	9/3/2013	8/30/2019
Inactive	Golden Rule Insurance Company	301943	Agent - Life	9/3/2013	8/30/2019
Active	Grange Indemnity Insurance Company	300793	Agent - Casualty	10/4/2019
Active	Grange Indemnity Insurance Company	300793	Agent - Property	10/4/2019
Active	Grange Insurance Company	300234	Agent - Casualty	10/4/2019
Active	Grange Insurance Company	300234	Agent - Property	10/4/2019
Inactive	Grange Life Insurance Company	300128	Agent - Health	1/26/2014	9/11/2018
Inactive	Grange Life Insurance Company	300128	Agent - Life	1/26/2014	9/11/2018
Active	Grange Property & Casualty Insurance Company	601680	Agent - Casualty	10/4/2019
Active	Grange Property & Casualty Insurance Company	601680	Agent - Property	10/4/2019
Active	Hanover American Insurance Company (The)	300447	Agent - Casualty	10/1/2018
Active	Hanover American Insurance Company (The)	300447	Agent - Property	10/1/2018
Active	Hanover Insurance Company (The)	300508	Agent - Casualty	10/1/2018
Active	Hanover Insurance Company (The)	300508	Agent - Property	10/1/2018
Inactive	Hartford Insurance Company of the Southeast	1014204	Agent - Casualty	4/28/2021	7/24/2023
Inactive	Hartford Insurance Company of the Southeast	1014204	Agent - Property	4/28/2021	7/24/2023
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Casualty	10/31/2021	7/24/2023
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Property	10/31/2021	7/24/2023
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	5/14/2014	5/4/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	6/16/2015	5/2/2016
Inactive	Humana Insurance Company	301104	Agent - Health	6/16/2015	12/8/2015
Inactive	Humana Insurance Company	301104	Agent - Life	9/4/2013	5/4/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/4/2013	5/4/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	5/14/2014	5/4/2015
Inactive	HumanaDental Insurance Company	301457	Agent - Health	3/19/2012	12/19/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	3/19/2012	12/19/2012
Active	Insurance Company of the West	301520	Agent - Casualty	11/16/2018
Active	Insurance Company of the West	301520	Agent - Property	11/16/2018
Inactive	Kanawha Insurance Company	300127	Agent - Health	6/16/2015	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	6/16/2015	10/22/2015
Active	MICO Insurance Company	301664	Agent - Casualty	10/28/2021
Active	MICO Insurance Company	301664	Agent - Property	10/28/2021
Active	Massachusetts Bay Insurance Company	300898	Agent - Casualty	10/1/2018
Active	Massachusetts Bay Insurance Company	300898	Agent - Property	10/1/2018
Active	Motorists Commercial Mutual Insurance Company	301941	Agent - Casualty	1/22/2020
Active	Motorists Commercial Mutual Insurance Company	301941	Agent - Property	1/22/2020
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	3/26/2020	2/20/2022
Active	National Builders Insurance Company	677579	Agent - Casualty	8/5/2021
Active	National Builders Insurance Company	677579	Agent - Property	8/5/2021
Active	NorGUARD Insurance Company	500015	Agent - Casualty	11/11/2019
Active	NorthStone Insurance Company	818905	Agent - Casualty	9/30/2020
Active	Ohio Casualty Insurance Company	301492	Agent - Casualty	2/4/2022
Active	Ohio Casualty Insurance Company	301492	Agent - Property	2/4/2022
Active	Old Republic Insurance Company	301225	Agent - Casualty	6/28/2023
Inactive	Owners Insurance Company	300796	Agent - Casualty	9/9/2014	9/4/2018
Inactive	Owners Insurance Company	300796	Agent - Property	9/9/2014	9/4/2018
Active	Pan-American Life Insurance Company	301530	Agent - Life	1/1/2024
Active	PinnaclePoint Insurance Company	819085	Agent - Casualty	9/30/2020
Active	Plaza Insurance Company	300748	Agent - Casualty	3/4/2022
Active	Plaza Insurance Company	300748	Agent - Property	3/4/2022
Active	Property and Casualty Insurance Company of Hartford	301409	Agent - Casualty	7/3/2024
Active	Property and Casualty Insurance Company of Hartford	301409	Agent - Property	7/3/2024
Active	SAFECO Insurance Company of America	300159	Agent - Casualty	1/11/2016
Active	SAFECO Insurance Company of America	300159	Agent - Property	1/11/2016
Active	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	3/31/2023
Active	SAFECO Insurance Company of Illinois	301350	Agent - Property	3/31/2023
Inactive	Selective Insurance Company of America	500018	Agent - Casualty	3/12/2014	9/4/2018
Inactive	Selective Insurance Company of America	500018	Agent - Property	3/12/2014	9/4/2018
Inactive	Selective Insurance Company of South Carolina	500012	Agent - Casualty	3/12/2014	9/4/2018
Inactive	Selective Insurance Company of South Carolina	500012	Agent - Property	3/12/2014	9/4/2018
Inactive	Selective Insurance Company of the Southeast	300381	Agent - Casualty	3/12/2014	9/4/2018
Inactive	Selective Insurance Company of the Southeast	300381	Agent - Property	3/12/2014	9/4/2018
Active	Sentinel Insurance Company, Limited	501696	Agent - Casualty	1/11/2023
Active	Sentinel Insurance Company, Limited	501696	Agent - Property	1/11/2023
Active	State Automobile Mutual Insurance Company	301824	Agent - Casualty	6/16/2021
Active	State Automobile Mutual Insurance Company	301824	Agent - Property	6/16/2021
Active	SummitPoint Insurance Company	819084	Agent - Casualty	9/30/2020
Active	Trumbull Insurance Company	300242	Agent - Casualty	2/20/2024
Active	Trumbull Insurance Company	300242	Agent - Property	2/20/2024
Active	Trustgard Insurance Company	300104	Agent - Casualty	10/4/2019
Active	Trustgard Insurance Company	300104	Agent - Property	10/4/2019
Active	U.S. Specialty Insurance Company	300186	Agent - Casualty	2/5/2019
Active	U.S. Specialty Insurance Company	300186	Agent - Property	2/5/2019
Inactive	United World Life Insurance Company	300532	Agent - Health	3/26/2020	2/20/2022
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	3/26/2020	2/20/2022
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	3/26/2020	2/20/2022
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	10/17/2018	7/1/2019
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	10/17/2018	7/1/2019
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	11/12/2015	11/4/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	11/12/2015	11/4/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	10/17/2018	7/1/2019
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	10/17/2018	7/1/2019
Active	Verlan Fire Insurance Company	517102	Agent - Casualty	10/1/2018
Active	Verlan Fire Insurance Company	517102	Agent - Property	10/1/2018
Active	Westfield Insurance Company	301950	Agent - Casualty	9/24/2020
Active	Westfield Insurance Company	301950	Agent - Property	9/24/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Bna Insurance Group, LLC	1010381	Agent - Health	9/19/2018
Active	Bna Insurance Group, LLC	1010381	Agent - Life	9/19/2018
Active	Bna Insurance Group, LLC	1010381	Agent - Casualty	9/19/2018
Active	Bna Insurance Group, LLC	1010381	Agent - Property	9/19/2018
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/13/2013	11/2/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Life	9/4/2013	11/2/2016
Active	Ins Professionals Of Tennessee LLC	773829	Agent - Casualty	9/9/2014
Active	Ins Professionals Of Tennessee LLC	773829	Agent - Property	9/9/2014
Inactive	TZ Insurance Solutions LLC	727470	Agent - Health	11/4/2011	3/27/2012