DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Burgio, Donald Michael	DOIID	769945	NAIC NPN	12119105

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	12/1/2011	7/10/2014
Inactive	Non Resident	Agent	Life	12/1/2011	7/10/2014
* 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	Berkshire Life Insurance Company of America	300983	Agent - Health	2/16/2012	7/10/2014
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	2/16/2012	7/10/2014
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/22/2013	5/1/2014
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	2/16/2012	7/10/2014
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	2/16/2012	7/10/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	1/31/2013	5/1/2014
Inactive	Humana Insurance Company	301104	Agent - Health	1/31/2013	5/1/2014
Inactive	Humana Insurance Company	301104	Agent - Life	1/31/2013	5/1/2014
Inactive	Kanawha Insurance Company	300127	Agent - Health	1/31/2013	5/1/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	1/31/2013	5/1/2014
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	12/12/2011	7/10/2014
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	12/12/2011	7/10/2014
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	12/12/2011	7/10/2014
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	12/12/2011	7/10/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	2/13/2012	7/10/2014
Inactive	Paychex Insurance Agency Inc	509469	Agent - Life	12/19/2011	7/10/2014
Inactive	Paychex Insurance Agency Inc	509469	Agent - Health	12/19/2011	7/10/2014