DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Black, Angela Mary	DOIID	327067	NAIC NPN	253717

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	7/6/1989	10/31/2017
Inactive	Non Resident	Agent	Life	7/6/1989	10/31/2017
* 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	Chesapeake Life Insurance Company (The)	301017	Agent - Health	9/18/2002	5/13/2008
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	9/18/2002	5/13/2008
Inactive	MEGA Life and Health Insurance Company (The)	300751	Agent - Health	7/6/1989	10/20/2009
Inactive	MEGA Life and Health Insurance Company (The)	300751	Agent - Life	7/6/1989	10/20/2009
Inactive	Mid-West National Life Insurance Company of Tennessee	300097	Agent - Health	7/6/1989	2/22/2008
Inactive	Mid-West National Life Insurance Company of Tennessee	300097	Agent - Life	7/6/1989	2/22/2008
Inactive	Pan-American Life Insurance Company	301530	Agent - Health	12/28/2010	10/9/2013
Inactive	Pan-American Life Insurance Company	301530	Agent - Life	12/28/2010	10/9/2013
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	9/15/2016	10/31/2017
Inactive	United States Fire Insurance Company	582240	Agent - Health	11/29/2011	10/31/2017
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	9/29/2009	12/1/2016
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	9/29/2009	12/1/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	9/29/2009	12/1/2016
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	9/29/2009	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	Ins Office Of America Inc	616585	Agent - Life	8/3/2010	4/7/2011
Inactive	Ins Office Of America Inc	616585	Agent - Health	8/3/2010	4/7/2011