DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Douglas, Tamonica Lavell	DOIID	1013461	NAIC NPN	18909247

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/4/2018	8/31/2021
* 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
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	9/26/2019	7/9/2021
Inactive	Aetna Life Insurance Company	301140	Agent - Health	9/26/2019	7/9/2021
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	8/18/2020	1/28/2021
Inactive	SilverScript Insurance Company	663526	Agent - Health	9/26/2019	7/9/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Health	10/10/2018	12/29/2018