DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Pack, Lori Ellyn	DOIID	1065216	NAIC NPN	18012361

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	11/14/2019		9/30/2025
Active	Non Resident	Agent	Life	11/14/2019		9/30/2025
Active	Non Resident	Agent	Health	11/14/2019		9/30/2025
Active	Non Resident	Agent	Property	11/14/2019		9/30/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	1/5/2022		9/30/2025
* 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	07/15/2025	09/30/2025
Surplus Lines Broker	07/15/2025	09/30/2025

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	RSG Specialty, LLC	726176	Agent - Casualty
Denied	RSG Specialty, LLC	726176	Agent - Life
Denied	RSG Specialty, LLC	726176	Agent - Health
Denied	RSG Specialty, LLC	726176	Agent - Property