DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Blackwell, La Donna Ann	DOIID	1139934	NAIC NPN	17795349

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	6/16/2021		1/31/2026
Active	Non Resident	Agent	Property	6/16/2021		1/31/2026
* 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
Agent	11/15/2025	01/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	New York Marine and General Insurance Company	301932	Agent - Casualty	11/2/2021
Active	New York Marine and General Insurance Company	301932	Agent - Property	11/2/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Avalon Risk Management Insurance Agency LLC	709353	Agent - Casualty	11/2/2021
Active	Avalon Risk Management Insurance Agency LLC	709353	Agent - Property	11/2/2021