DEPARTMENT OF INSURANCE
Affiliations
NameSpace, David DOIID946445NAIC NPN17761766
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentHealth3/2/20172/28/2019 
InactiveNon ResidentAgentVariable Life and Variable Annuities1/14/20202/28/2021 
InactiveNon ResidentAgentLife1/14/20202/28/2021 
* 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
InactiveBrighthouse Life Insurance Company301829Agent - Life7/10/20202/28/2021
InactiveBrighthouse Life Insurance Company301829Agent - Variable Life and Variable Annuities7/10/20202/28/2021
InactiveFortitude Life Insurance & Annuity Company301503Agent - Life5/3/201812/26/2018
InactiveMinnesota Life Insurance Company300488Agent - Health3/9/201710/25/2017
InactiveMinnesota Life Insurance Company300488Agent - Life3/9/201710/25/2017
InactiveMinnesota Life Insurance Company300488Agent - Variable Life and Variable Annuities3/9/201710/25/2017
InactivePruco Life Insurance Company300954Agent - Life1/17/20207/7/2020
InactivePruco Life Insurance Company300954Agent - Variable Life and Variable Annuities1/17/20207/7/2020
InactivePrudential Insurance Company of America300784Agent - Health5/3/201812/26/2018
InactivePrudential Insurance Company of America300784Agent - Life1/17/20207/7/2020
InactivePrudential Insurance Company of America300784Agent - Variable Life and Variable Annuities1/17/20207/7/2020
InactiveUnitedHealthcare Insurance Company300946Agent - Health12/17/20184/30/2019
InactiveUnitedHealthcare Insurance Company300946Agent - Life12/17/20184/30/2019
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health12/17/20184/30/2019
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health12/17/20184/30/2019
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveMerrill Lynch Life Agency Inc.400527Agent - Life7/10/20202/28/2021
InactiveMerrill Lynch Life Agency Inc.400527Agent - Variable Life and Variable Annuities7/10/20202/28/2021

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