DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Blalock, Sandra J	DOIID	1038053	NAIC NPN	17634726

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	4/25/2019	1/31/2023
Inactive	Non Resident	Agent	Health	4/25/2019	1/31/2023
* 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	5/9/2019	5/30/2022
Inactive	Anthem Life Insurance Company	301209	Agent - Life	5/9/2019	5/30/2022

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	5/9/2019	5/30/2022
Inactive	Designated Agent Company Inc.	681257	Agent - Health	5/9/2019	5/30/2022
Inactive	Paychex Insurance Agency Inc	509469	Agent - Life	5/9/2019	4/22/2022
Inactive	Paychex Insurance Agency Inc	509469	Agent - Health	5/9/2019	4/22/2022