DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Chouinard, Marc Daniel	DOIID	964455	NAIC NPN	15852638

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	8/22/2017	4/30/2023
Inactive	Non Resident	Agent	Life	8/22/2017	4/30/2023
* 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	Fidelity Investments Life Insurance Company	300620	Agent - Health	9/19/2017	5/11/2020
Inactive	Fidelity Investments Life Insurance Company	300620	Agent - Life	9/19/2017	5/11/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Fidelity Health Insurance Services LLC	887889	Agent - Health
Denied	Fidelity Health Insurance Services LLC	887889	Agent - Life