DEPARTMENT OF INSURANCE

Affiliations

Name	Dominguez, Leticia Gay	DOIID	316817	NAIC NPN	7164020

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	General Lines	8/20/1999	8/15/2000
Inactive	Resident	Agent	Casualty	8/15/2000	11/1/2009
Inactive	Resident	Agent	Property	8/15/2000	11/1/2009
Inactive	Resident	Agent	Health	10/12/2001	11/1/2009
Inactive	Resident	Agent	Life	10/12/2001	11/1/2009
* 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	Anthem Life Insurance Company	301209	Agent - Health	10/12/2001	11/1/2009
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/12/2001	11/1/2009
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	3/27/2009	11/1/2009
Inactive	CompBenefits Insurance Company	301864	Agent - Health	3/27/2009	11/1/2009
Inactive	CompBenefits Insurance Company	301864	Agent - Life	3/27/2009	11/1/2009
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	5/30/2007	11/1/2009
Inactive	Grange Indemnity Insurance Company	300793	Agent - General Lines	9/20/1999	8/15/2000
Inactive	Grange Insurance Company	300234	Agent - Casualty	8/15/2000	11/1/2009
Inactive	Grange Insurance Company	300234	Agent - General Lines	8/20/1999	8/15/2000
Inactive	Grange Insurance Company	300234	Agent - Property	8/15/2000	11/1/2009
Inactive	Grange Life Insurance Company	300128	Agent - Health	10/13/1998	10/19/2000
Inactive	Grange Life Insurance Company	300128	Agent - Life	10/13/1998	10/19/2000
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/20/2009	11/1/2009
Inactive	Humana Insurance Company	301104	Agent - Health	10/10/2006	11/1/2009
Inactive	Humana Insurance Company	301104	Agent - Life	10/10/2006	11/1/2009
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/10/2006	11/1/2009
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	10/10/2006	11/1/2009
Inactive	HumanaDental Insurance Company	301457	Agent - Health	4/11/2007	11/1/2009
Inactive	HumanaDental Insurance Company	301457	Agent - Life	4/11/2007	11/1/2009
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/11/2008	11/1/2009
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/11/2008	11/1/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Cole & Durham Ins Inc	398448	Agent - Life	11/30/1998	10/19/2000
Inactive	Cole & Durham Ins Inc	398448	Agent - Health	11/30/1998	10/19/2000
Inactive	Preferred Benefits LLC	550000	Agent - Life	7/2/2003	11/1/2009
Inactive	Preferred Benefits LLC	550000	Agent - Health	7/2/2003	11/1/2009
Inactive	Preferred Benefits LLC	550000	Agent - Property	9/13/2006	11/1/2009
Inactive	Preferred Benefits LLC	550000	Agent - Casualty	9/13/2006	11/1/2009
Inactive	West Kentucky Group Benefits	401049	Agent - Life	12/28/1998	10/19/2000
Inactive	West Kentucky Group Benefits	401049	Agent - Health	12/28/1998	10/19/2000