DEPARTMENT OF INSURANCE
Affiliations
NameBurse, Derren DOIID909659NAIC NPN16368552
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentHealth3/11/20161/31/2022 
InactiveNon ResidentAgentLife3/11/20161/31/2022 
InactiveNon ResidentAgentVariable Life and Variable Annuities3/11/20161/31/2022 
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveMutual of Omaha Insurance Company301012Agent - Health11/16/201710/22/2018
InactiveNationwide Life and Annuity Insurance Company300714Agent - Health3/13/201812/17/2020
InactiveNationwide Life and Annuity Insurance Company300714Agent - Life3/13/201812/17/2020
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
DeniedCrump Life Insurance Services LLC505491Agent - Life  
DeniedCrump Life Insurance Services LLC505491Agent - Health  
DeniedCrump Life Insurance Services LLC505491Agent - Variable Life and Variable Annuities  
DeniedMcgriff Insurance Services, LLC400877Agent - Life  
InactiveMcgriff Insurance Services, LLC400877Agent - Health11/16/201712/17/2020

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