DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Mbanasor, Peter J	DOIID	1152883	NAIC NPN	20032626

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Life	9/8/2021		12/31/2024
Active	Resident	Agent	Health	10/8/2021		12/31/2024
* 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	10/15/2024	12/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	5/16/2024
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	5/16/2024
Active	Anthem Life Insurance Company	301209	Agent - Life	5/16/2024
Inactive	Northwestern Long Term Care Insurance Company	300135	Agent - Health	5/19/2022	12/5/2023
Inactive	Northwestern Mutual Life Insurance Company	300931	Agent - Health	10/11/2021	12/5/2023
Inactive	Northwestern Mutual Life Insurance Company	300931	Agent - Life	10/11/2021	12/5/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	The Underwriters Group, Inc	674720	Agent - Life	5/16/2024
Active	The Underwriters Group, Inc	674720	Agent - Health	5/16/2024