DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Blain, David Albert	DOIID	788608	NAIC NPN	16756054

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	8/30/2012	10/1/2014
Inactive	Resident	Agent	Health	9/11/2012	10/1/2014
* 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	Massachusetts Mutual Life Insurance Company	300445	Agent - Health	10/22/2012	3/27/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Al Torstrick Insurance Agency, LLC	400026	Agent - Life
Denied	Al Torstrick Insurance Agency, LLC	400026	Agent - Health