DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Shields, Charles L	DOIID	330459	NAIC NPN	1003410

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	5/7/1997	8/1/2019
Inactive	Non Resident	Agent	Life	5/7/1997	8/1/2019
Active	Non Resident	Independent Adjuster	Property & Casualty	4/30/1999		8/31/2025
* 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
Independent Adjuster	06/15/2025	08/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American National Insurance Company	301861	Agent - Health	1/18/2011	8/1/2019
Inactive	American National Insurance Company	301861	Agent - Life	1/18/2011	8/1/2019
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Health	1/7/2005	8/1/2019
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Life	1/7/2005	8/1/2019
Inactive	National Guardian Life Insurance Company	300596	Agent - Health	5/7/1997	12/1/1998
Inactive	National Guardian Life Insurance Company	300596	Agent - Life	5/7/1997	12/1/1998

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American National Property and Casualty Company	300392	Independent Adjuster - Property & Casualty	4/30/1999	3/21/2008
Inactive	Regional Ins Service Co Inc	397548	Agent - Life	9/18/2018	8/1/2019
Inactive	Regional Ins Service Co Inc	397548	Agent - Health	9/18/2018	8/1/2019