DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Clemente, Donna	DOIID	1058089	NAIC NPN	332525

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	9/26/2019		7/31/2025
Active	Non Resident	Agent	Life	9/26/2019		7/31/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	05/15/2025	07/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American General Life Insurance Company	301585	Agent - Health	12/8/2020
Active	American General Life Insurance Company	301585	Agent - Life	12/8/2020
Active	Thrivent Financial for Lutherans	301101	Agent - Health	5/17/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Chernoff Diamond & Co LLC	691341	Agent - Life	2/24/2021
Active	Chernoff Diamond & Co LLC	691341	Agent - Health	11/9/2021