DEPARTMENT OF INSURANCE

Affiliations

Name	Bloom Health Services, LLC	DOIID	796292	NAIC NPN	16817845

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Administrator	Not Applicable	10/29/2012	3/31/2020
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Ciolko, Marek Paul	754271	Administrator - Not Applicable	10/29/2012	3/31/2020