DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Tholen, Timothy	DOIID	1000866	NAIC NPN	17205569

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	7/13/2018		11/30/2026
Active	Non Resident	Agent	Property	7/13/2018		11/30/2026
* 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

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Liberty Insurance Underwriters Inc.	301391	Agent - Casualty	9/10/2018
Active	Liberty Insurance Underwriters Inc.	301391	Agent - Property	9/10/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Mercer Health & Benefits Administration LLC	656414	Agent - Casualty	1/28/2019
Active	Mercer Health & Benefits Administration LLC	656414	Agent - Property	1/28/2019