DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Acrisure Wallstreet Partners, LLC	DOIID	1020531	NAIC NPN	18293503

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	11/29/2018		3/31/2026
Active	Non Resident	Agent	Health	11/29/2018		3/31/2026
* 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	Accendo Insurance Company	300312	Agent - Life	12/18/2020
Active	Aetna Health Inc. (PA)	660717	Agent - Health	2/24/2020
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	12/18/2020
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/6/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	2/24/2020
Active	Aetna Life Insurance Company	301140	Agent - Life	2/24/2020
Inactive	American Continental Insurance Company	643130	Agent - Life	12/18/2020	8/11/2021
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	1/24/2019
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	1/24/2019
Active	Continental American Insurance Company	301700	Agent - Health	3/18/2019
Active	Continental American Insurance Company	301700	Agent - Life	3/18/2019
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	12/18/2020
Active	Great Midwest Insurance Company	301418	Agent - Health	6/17/2019
Active	Imperium Insurance Company	300804	Agent - Health	6/17/2019
Active	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	4/2/2019
Active	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	4/2/2019
Active	SilverScript Insurance Company	663526	Agent - Health	11/1/2019
Active	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	4/7/2022
Active	WellCare Prescription Insurance Inc.	654329	Agent - Health	4/7/2022

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Ackles, Judy Ann	748728	Agent - Life
Inactive	Cliburn, David	1088239	Agent - Health	7/21/2020	6/14/2024
Inactive	Cliburn, David	1088239	Agent - Life	7/21/2020	6/14/2024
Active	Kolenda, Courtney Lynne	1022910	Agent - Health	6/10/2019
Active	Kolenda, Courtney Lynne	1022910	Agent - Life	7/1/2019
Inactive	Parker, William L	511526	Agent - Health	11/29/2018	1/22/2020
Inactive	Parker, William L	511526	Agent - Life	11/29/2018	1/22/2020
Active	Sepesi, Jeffrey P	321030	Agent - Health	12/17/2021
Active	Sepesi, Jeffrey P	321030	Agent - Life	12/17/2021
Inactive	Wilbers, Leroy	1021275	Agent - Health	7/30/2019	6/2/2020
Inactive	Wilbers, Leroy	1021275	Agent - Life	7/30/2019	6/2/2020