DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	National Brokerage Atlantic Inc	DOIID	1037431	NAIC NPN	16192316

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	4/22/2019		3/31/2027
Active	Non Resident	Agent	Health	4/22/2019		3/31/2027
* 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	Allianz Life Insurance Company of North America	301791	Agent - Life	8/10/2020
Active	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	6/26/2024
Active	Forethought Life Insurance Company	301407	Agent - Health	8/20/2019
Active	Forethought Life Insurance Company	301407	Agent - Life	8/20/2019
Active	Pacific Life Insurance Company	301848	Agent - Health	6/6/2025
Active	Pacific Life Insurance Company	301848	Agent - Life	6/6/2025
Active	Pruco Life Insurance Company	300954	Agent - Health	4/7/2022
Active	Pruco Life Insurance Company	300954	Agent - Life	4/7/2022

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Milliron, James Miles	975738	Agent - Health	4/22/2019
Active	Milliron, James Miles	975738	Agent - Life	4/22/2019