DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Grossman, Constance Faye	DOIID	501773	NAIC NPN	7210926

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Limited Line Credit	9/8/2009	4/30/2020
Inactive	Resident	Agent	Life	2/28/2006	5/1/2008
Inactive	Resident	Agent	Credit Life & Health	2/11/2000	8/7/2000
* 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	Investors Heritage Life Insurance Company	300363	Agent - Life	8/28/2007	5/1/2008
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Limited Line Credit	9/8/2009	6/22/2020
Inactive	Lyndon Southern Insurance Company	609602	Agent - Limited Line Credit	2/10/2017	4/30/2020
Inactive	Protective Life Insurance Company	300638	Agent - Life	3/10/2006	5/1/2008
Inactive	Southern Financial Life Insurance Company	300664	Agent - Credit Life & Health	2/11/2000	8/7/2000
Inactive	Southern Financial Life Insurance Company	300664	Agent - Limited Line Credit	2/10/2017	4/30/2020
Inactive	Western National Life Insurance Company	300461	Agent - Life	3/7/2006	8/23/2007
Inactive	Western-Southern Life Assurance Company	301590	Agent - Life	2/28/2006	5/1/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Integra Bank National Association	558914	Agent - Life	11/7/2006	5/23/2007