DEPARTMENT OF INSURANCE

Name	Blaylock, Derek Alan	DOIID	515469	NAIC NPN	3648981

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Non Resident	Agent	Property	9/21/2000	11/30/2003
Inactive	Non Resident	Agent	Casualty	9/21/2000	11/30/2003

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

No License Renewal Information

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date. Licensees subject to CE must complete CE requirements before Next Compliance Date in order to successfully complete the License Renewal Process.

Address Information

Type	Address
Business / Home Office	4000 W. 114th St. Suite 300Leawood, KS 66211
Residence	Not Public Information