DEPARTMENT OF INSURANCE
Affiliations
NameGrucza, Douglas AndrewDOIID816224NAIC NPN2356076
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAdministratorNot Applicable8/5/20134/30/2015 
InactiveNon ResidentAgentHealth8/1/20134/30/2015 
InactiveNon ResidentAgentLife8/1/20134/30/2015 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveHartford Life and Accident Insurance Company300878Agent - Health10/4/20135/30/2015
InactiveHartford Life and Accident Insurance Company300878Agent - Life10/4/20135/30/2015
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveLifetime Benefit Solutions, Inc.574373Agent - Life11/11/20134/30/2015
InactiveLifetime Benefit Solutions, Inc.574373Agent - Health11/11/20134/30/2015
InactiveLifetime Benefit Solutions, Inc.574373Administrator - Not Applicable8/12/201311/13/2013

© Commonwealth of Kentucky. All rights reserved.