DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Lyskowski, Dalton	DOIID	971307	NAIC NPN	18555874

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/6/2017	9/9/2022
* 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
Denied	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health
Denied	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health
Denied	Anthem Insurance Companies, Inc.	300941	Agent - Health
Denied	Compcare Health Services Insurance Corporation	948751	Agent - Health

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Health	8/15/2019	7/28/2022