DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Vibrock, Timothy C	DOIID	1039541	NAIC NPN	737576

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	5/7/2019		4/30/2025
Active	Non Resident	Agent	Life	5/7/2019		4/30/2025
* 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	UnitedHealthcare Insurance Company	300946	Agent - Health	5/29/2019
Active	UnitedHealthcare Insurance Company	300946	Agent - Life	5/29/2019
Active	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	5/29/2019
Active	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	5/29/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Dental Choice Agency Inc.	398085	Agent - Health	4/19/2022