DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Larson, Penny J	DOIID	1039994	NAIC NPN	8765209

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	3/24/2021	9/30/2021
Inactive	Non Resident	Agent	Property	5/10/2019	9/30/2021
Inactive	Non Resident	Agent	Casualty	5/10/2019	9/30/2021
* 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 Health Plans of Kentucky, Inc.	300999	Agent - Health	5/5/2021	9/30/2021
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	6/24/2021	9/30/2021
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	5/14/2019	6/8/2020
Inactive	Bristol West Insurance Company	301655	Agent - Property	5/14/2019	6/8/2020
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	3/26/2021	7/28/2021
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	3/26/2021	7/28/2021
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	3/26/2021	7/28/2021
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	3/26/2021	7/28/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Fx Insurance Agency, LLC	646184	Agent - Casualty	5/14/2019	6/8/2020
Inactive	Fx Insurance Agency, LLC	646184	Agent - Property	5/14/2019	6/8/2020