DEPARTMENT OF INSURANCE

Affiliations

Name	Roark, Lisa C	DOIID	322768	NAIC NPN	1870701

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Life	10/8/1997	10/31/2020
Inactive	Resident	Agent	Health	10/8/1997	10/31/2020
* 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	American United Life Insurance Company	300498	Agent - Health	12/1/2004	10/31/2020
Inactive	American United Life Insurance Company	300498	Agent - Life	12/1/2004	10/31/2020
Inactive	Banner Life Insurance Company	301696	Agent - Life	6/22/2011	8/21/2014
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	2/6/2006	10/12/2020
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	2/6/2006	10/12/2020
Inactive	Brighthouse Life Insurance Company	301829	Agent - Health	11/14/2014	10/31/2020
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	11/14/2014	10/31/2020
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	7/6/2011	12/5/2014
Inactive	CompBenefits Insurance Company	301864	Agent - Health	7/6/2011	11/21/2011
Inactive	CompBenefits Insurance Company	301864	Agent - Life	7/6/2011	11/21/2011
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	10/8/1997	1/12/2005
Inactive	Connecticut General Life Insurance Company	301333	Agent - Life	10/8/1997	1/12/2005
Inactive	Continental Casualty Company	301019	Agent - Health	12/8/2003	12/16/2004
Inactive	Dental Care Plus Inc.	301495	Agent - Health	12/18/2013	2/20/2014
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	2/26/2007	8/14/2015
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Health	5/18/2009	10/31/2020
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Life	5/18/2009	10/31/2020
Inactive	First Colony Life Insurance Company	301179	Agent - Life	8/18/2005	1/1/2007
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Health	6/12/2009	12/7/2012
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	1/1/2007	12/7/2012
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	2/6/2006	12/30/2020
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	2/6/2006	12/30/2020
Inactive	Hartford Life Group Insurance Company	301708	Agent - Health	2/20/2004	12/31/2006
Inactive	Hartford Life Group Insurance Company	301708	Agent - Life	2/20/2004	12/31/2006
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	12/18/2006	11/16/2011
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	12/18/2006	11/16/2011
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	5/13/2013	12/5/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	8/16/2006	8/14/2015
Inactive	Humana Insurance Company	301104	Agent - Health	8/16/2006	8/14/2015
Inactive	Humana Insurance Company	301104	Agent - Life	8/16/2006	8/14/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	8/16/2006	12/5/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	8/16/2006	12/5/2014
Inactive	HumanaDental Insurance Company	301457	Agent - Health	7/6/2011	12/19/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	7/6/2011	12/19/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/11/2008	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/11/2008	12/5/2014
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	12/13/2019	10/31/2020
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	12/13/2019	10/31/2020
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Health	12/1/2009	11/14/2014
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	12/1/2009	11/14/2014
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	12/5/2011	10/31/2020
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	12/5/2011	10/31/2020
Inactive	Reliance Standard Life Insurance Company	300584	Agent - Health	9/7/2008	10/31/2020
Inactive	Reliance Standard Life Insurance Company	300584	Agent - Life	9/7/2008	10/31/2020
Inactive	Standard Insurance Company	300185	Agent - Health	3/3/2006	10/31/2020
Inactive	Standard Insurance Company	300185	Agent - Life	3/3/2006	10/31/2020
Inactive	Sun Life Assurance Company of Canada	301811	Agent - Health	6/21/2009	8/22/2011
Inactive	Sun Life Assurance Company of Canada	301811	Agent - Life	6/21/2009	8/22/2011
Inactive	Sun Life and Health Insurance Company (U.S.)	300801	Agent - Health	2/20/2004	8/22/2011
Inactive	Sun Life and Health Insurance Company (U.S.)	300801	Agent - Life	2/20/2004	8/22/2011
Inactive	Superior Dental Care Inc.	300418	Agent - Health	12/28/2009	10/31/2020
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	12/5/2011	10/31/2020
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	12/5/2011	10/31/2020
Inactive	Union Security Insurance Company	301844	Agent - Health	4/20/2004	1/11/2015
Inactive	Union Security Insurance Company	301844	Agent - Life	4/20/2004	1/11/2015
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	6/1/2004	12/14/2009
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	6/1/2004	12/14/2009
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	6/1/2004	12/14/2009
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	6/1/2004	12/14/2009
Inactive	West Coast Life Insurance Company	301607	Agent - Life	7/19/2007	11/16/2011
Inactive	Wilcac Life Insurance Company	301573	Agent - Health	2/20/2004	12/16/2004
Inactive	Wilcac Life Insurance Company	301573	Agent - Life	2/20/2004	12/16/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Business Benefits Inc	400111	Agent - Life	1/5/2004	3/11/2015
Inactive	Business Benefits Inc	400111	Agent - Health	1/5/2004	3/11/2015
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	5/7/2010	5/3/2017
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/9/2013	10/31/2020
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/9/2013	10/31/2020