DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Jeffery, Carmen Lorena	DOIID	932051	NAIC NPN	2588904

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	10/6/2016	1/31/2018
Inactive	Non Resident	Agent	Health	10/6/2016	1/31/2018
Inactive	Non Resident	Agent	Property	10/6/2016	1/31/2018
Inactive	Non Resident	Agent	Life	10/6/2016	1/31/2018
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Tolman & Wiker Insurance Sercices, LLC	601153	Agent - Life	2/8/2017	1/31/2018
Inactive	Tolman & Wiker Insurance Sercices, LLC	601153	Agent - Health	2/8/2017	1/31/2018