DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Nichols, Bruce R	DOIID	1059094	NAIC NPN	10772715

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/3/2019	7/31/2022
Inactive	Non Resident	Agent	Life	10/3/2019	7/31/2022
* 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	Provident Life and Accident Insurance Company	301525	Agent - Health	10/16/2019	7/31/2022
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	10/16/2019	7/31/2022
Inactive	Starmount Life Insurance Company	628031	Agent - Health	10/16/2019	7/31/2022
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	10/16/2019	7/31/2022
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	10/16/2019	7/31/2022
Inactive	Unum Insurance Company	301499	Agent - Health	10/16/2019	7/31/2022
Inactive	Unum Insurance Company	301499	Agent - Life	10/16/2019	7/31/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Optavise, LLC	671337	Agent - Life	11/18/2019	7/31/2022
Inactive	Optavise, LLC	671337	Agent - Health	11/18/2019	7/31/2022