DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Black, Shameka Michelle	DOIID	1207265	NAIC NPN	19301241

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	5/25/2022	1/31/2024
Inactive	Non Resident	Agent	Life	5/25/2022	1/31/2024
* 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	Accendo Insurance Company	300312	Agent - Health	9/30/2022	3/15/2023
Inactive	Accendo Insurance Company	300312	Agent - Life	9/30/2022	3/15/2023
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	9/30/2022	3/15/2023
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Health	11/21/2022	1/31/2024
Inactive	CareSource Kentucky Co.	838179	Agent - Health	9/29/2022	11/20/2023
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	9/30/2022	3/15/2023
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	9/30/2022	3/15/2023
Inactive	Great Southern Life Insurance Company	301443	Agent - Health	6/3/2022	12/11/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Health Iq Insurance Services, Inc	882220	Agent - Life	9/30/2022	3/2/2023