DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Kirby, Georgia	DOIID	1079889	NAIC NPN	16203778

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	3/31/2020	5/31/2022
Inactive	Non Resident	Agent	Life	3/31/2020	5/31/2022
* 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	UnitedHealthcare Insurance Company	300946	Agent - Health	5/1/2020	5/31/2022
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	5/1/2020	5/31/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	5/1/2020	5/31/2022
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	5/1/2020	5/31/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Willis Towers Watson Midwest, Inc.	534348	Agent - Life	5/1/2020	7/20/2021
Inactive	Willis Towers Watson Midwest, Inc.	534348	Agent - Health	5/1/2020	7/20/2021