DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Mendoza, Martha	DOIID	1241244	NAIC NPN	19460528

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Pending Replacement	Non Resident	Agent	Life	11/8/2022		6/30/2024
Pending Replacement	Non Resident	Agent	Health	11/8/2022		6/30/2024
* 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	04/15/2024	06/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Pending Replacement	Aetna Health Inc. (PA)	660717	Agent - Health	5/24/2023
Pending Replacement	Aetna Health of Ohio Inc.	1065035	Agent - Health	5/24/2023
Pending Replacement	Aetna Life Insurance Company	301140	Agent - Health	5/24/2023
Pending Replacement	SilverScript Insurance Company	663526	Agent - Health	5/24/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Optavise, LLC	671337	Agent - Life
Denied	Optavise, LLC	671337	Agent - Health