DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Slate Rx, LLC	DOIID	1317275	NAIC NPN	21031180

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Pharmacy Benefit Managers	Not Applicable	1/18/2024		3/31/2025
* 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
Pharmacy Benefit Managers	01/15/2025	03/31/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Dizenhouse, Joseph	732466	Administrator - Not Applicable	1/3/2024