DEPARTMENT OF INSURANCE

Affiliations

Name	Petter, Patricia M	DOIID	305340	NAIC NPN	1497403

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Health	1/27/2010	1/31/2026
Active	Resident	Agent	Life	1/27/2010	1/31/2026
* 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	CompBenefits Dental, Inc.	591692	Agent - Health	9/6/2011	12/10/2018
Inactive	CompBenefits Insurance Company	301864	Agent - Health	10/10/2011	6/26/2013
Inactive	CompBenefits Insurance Company	301864	Agent - Life	10/10/2011	6/26/2013
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	12/17/2018	4/9/2019
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	11/17/2014	12/10/2018
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/15/2018	4/9/2019
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/6/2011	12/10/2018
Inactive	Humana Insurance Company	301104	Agent - Health	9/6/2011	4/9/2019
Inactive	Humana Insurance Company	301104	Agent - Life	9/6/2011	4/9/2019
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	12/17/2018	4/9/2019
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	12/17/2018	4/9/2019
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	11/17/2014	12/10/2018
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	12/5/2016	12/10/2018
Inactive	HumanaDental Insurance Company	301457	Agent - Health	9/6/2011	2/23/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	9/6/2011	12/14/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/6/2011	5/4/2017
Inactive	Kanawha Insurance Company	300127	Agent - Life	9/6/2011	5/4/2017
Inactive	Principal Life Insurance Company	300129	Agent - Health	3/6/2000	1/31/2008
Inactive	Principal Life Insurance Company	300129	Agent - Life	3/6/2000	1/31/2008
Inactive	Union Security Insurance Company	301844	Agent - Health	12/20/1994	4/7/1997
Inactive	Union Security Insurance Company	301844	Agent - Life	12/20/1994	4/7/1997
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	8/18/2010	12/1/2016
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	8/18/2010	12/1/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	8/18/2010	12/1/2016
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	8/18/2010	12/1/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Rogers Benefit Group LLC	398725	Agent - Life	4/3/1995	4/7/1997
Inactive	Rogers Benefit Group LLC	398725	Agent - Health	4/3/1995	4/7/1997