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DEPARTMENT OF INSURANCE
Affiliations
Name
Black, Tori Ann
DOIID
1033751
NAIC NPN
17413735
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Inactive
Non Resident
Agent
Casualty
4/3/2019
6/23/2020
Inactive
Non Resident
Agent
Property
4/3/2019
6/23/2020
Inactive
Non Resident
Agent
Health
4/3/2019
6/23/2020
Inactive
Non Resident
Agent
Life
4/3/2019
6/23/2020
* 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
Guardian Life Insurance Company of America
301316
Agent - Health
4/1/2020
6/23/2020
Inactive
Guardian Life Insurance Company of America
301316
Agent - Life
4/1/2020
6/23/2020
Designated to act on behalf of the following Business Entities
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Denied
Paychex Insurance Agency Inc
509469
Agent - Casualty
Denied
Paychex Insurance Agency Inc
509469
Agent - Health
Denied
Paychex Insurance Agency Inc
509469
Agent - Life
Denied
Paychex Insurance Agency Inc
509469
Agent - Property
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