DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Mortezaie, Mohammad Russell	DOIID	1064766	NAIC NPN	19070399

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	11/10/2019	3/31/2024
Inactive	Non Resident	Agent	Life	11/10/2019	3/31/2024
* 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	11/22/2019	4/19/2020
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/22/2019	4/19/2020
Inactive	Golden Rule Insurance Company	301943	Agent - Health	11/25/2019	4/2/2024
Inactive	Golden Rule Insurance Company	301943	Agent - Life	11/25/2019	4/2/2024
Inactive	National Health Insurance Company	300554	Agent - Health	11/18/2020	3/31/2024
Inactive	National Health Insurance Company	300554	Agent - Life	11/18/2020	3/31/2024

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	11/22/2019	3/31/2024
Inactive	Designated Agent Company Inc.	681257	Agent - Health	11/22/2019	3/31/2024