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DEPARTMENT OF INSURANCE
Affiliations
Name
Town Square Bank
DOIID
399399
NAIC NPN
7221619
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Inactive
Resident
Agent
Life
11/1/2012
3/31/2019
Inactive
Resident
Agent
Limited Line Credit
6/21/2007
3/31/2019
Inactive
Resident
Agent
Health
11/1/2012
3/31/2019
* 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 National Insurance Company
301861
Agent - Health
12/28/2012
5/24/2019
Inactive
American National Insurance Company
301861
Agent - Life
12/28/2012
5/24/2019
Inactive
American National Insurance Company
301861
Agent - Limited Line Credit
3/5/2012
5/24/2019
Inactive
Investors Heritage Life Insurance Company
300363
Agent - Limited Line Credit
6/21/2007
3/31/2019
Inactive
Liberty Life Insurance Company
301542
Agent - Health
3/5/1982
4/22/2002
Inactive
Liberty Life Insurance Company
301542
Agent - Life
3/5/1982
4/22/2002
Denied
Life Investors Insurance Company of America
301793
Agent - Health
Denied
Life Investors Insurance Company of America
301793
Agent - Life
Designated Individuals
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Bays, Monica F
853662
Agent - Limited Line Credit
6/15/2015
5/24/2019
Inactive
Belt, Lisa Gaye
657261
Agent - Limited Line Credit
8/30/2012
3/31/2019
Inactive
Carter, Garen Douglas
332178
Agent - Health
3/5/1982
12/1/2000
Inactive
Carter, Garen Douglas
332178
Agent - Life
3/5/1982
12/1/2000
Inactive
Cobb, Eldon Thomas
393964
Agent - Life
6/15/2015
3/31/2019
Inactive
Cornwell, Peggy
786594
Agent - Limited Line Credit
10/2/2012
5/24/2019
Inactive
Curtis, Robert Stephen
340557
Agent - Limited Line Credit
6/21/2007
11/30/2009
Inactive
Daniel, Joshua Kade
583947
Agent - Health
11/1/2012
1/1/2016
Inactive
Daniel, Joshua Kade
583947
Agent - Life
11/1/2012
1/1/2016
Inactive
Daniel, Joshua Kade
583947
Agent - Limited Line Credit
4/12/2012
12/31/2017
Inactive
Fazenbaker, Debra A
719534
Agent - Limited Line Credit
10/1/2012
3/1/2013
Inactive
Gammon, Brenda Lee
687757
Agent - Limited Line Credit
5/22/2012
3/1/2013
Inactive
Gillum, Donna M
386796
Agent - Limited Line Credit
5/22/2012
1/31/2013
Inactive
Gullett, Cindy Joann
764736
Agent - Health
1/21/2014
9/1/2015
Inactive
Gullett, Cindy Joann
764736
Agent - Life
1/21/2014
9/1/2015
Inactive
Jackson, Jessica Rena
786588
Agent - Limited Line Credit
10/1/2012
5/24/2019
Inactive
Jones, Rhonda C
372953
Agent - Limited Line Credit
7/22/2015
4/30/2017
Inactive
King, James Wyatt
657270
Agent - Limited Line Credit
6/21/2007
1/31/2012
Inactive
Large, Matthew Ryan
817126
Agent - Limited Line Credit
1/21/2014
11/29/2017
Inactive
Pennington-Burchett, Kimberly Ann
717256
Agent - Limited Line Credit
10/3/2012
3/31/2014
Inactive
Smith, Kimberlee Diann
341445
Agent - Health
6/15/2015
3/31/2019
Inactive
Smith, Kimberlee Diann
341445
Agent - Life
6/15/2015
3/31/2019
Inactive
Smith, Kimberlee Diann
341445
Agent - Limited Line Credit
6/15/2015
3/31/2019
Inactive
Steger, Ryan Curtis
546105
Agent - Limited Line Credit
7/22/2015
8/31/2017
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