DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Williams, Dominque Alicia	DOIID	1030263	NAIC NPN	18805362

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	2/25/2019	10/31/2020
Inactive	Non Resident	Agent	Life	2/25/2019	10/31/2020
* 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	Anthem Life Insurance Company	301209	Agent - Health	3/20/2019	12/28/2019
Inactive	Anthem Life Insurance Company	301209	Agent - Life	3/20/2019	12/28/2019

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 - Life	3/20/2019	12/28/2019
Inactive	Designated Agent Company Inc.	681257	Agent - Health	3/20/2019	12/28/2019