DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Blaize, Merliss	DOIID	1074351	NAIC NPN	19392948

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Personal Lines	2/13/2020	7/6/2023
Inactive	Non Resident	Agent	Health	2/13/2020	7/6/2023
Inactive	Non Resident	Agent	Life	2/13/2020	7/6/2023
Active	Non Resident	Staff Adjuster	Property & Casualty	9/23/2022		7/31/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Staff Adjuster	05/15/2025	07/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	AMEX Assurance Company	301728	Agent - Health	5/5/2020	7/6/2023
Inactive	AMEX Assurance Company	301728	Agent - Personal Lines	5/5/2020	7/6/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Assurant Insurance Agency, Inc	559398	Agent - Life
Inactive	Assurant Insurance Agency, Inc	559398	Agent - Health	5/5/2020	6/21/2023