DEPARTMENT OF INSURANCE

Affiliations

Name	Willis Of Arizona Inc	DOIID	511502	NAIC NPN	660826

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	6/12/2008	3/6/2020
Inactive	Non Resident	Agent	Property	5/13/2011	3/6/2020
Inactive	Non Resident	Agent	Life	6/12/2008	3/6/2020
Inactive	Non Resident	Agent	Casualty	5/13/2011	3/6/2020
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	5/13/2011	3/6/2020
* 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	ACE American Insurance Company	300625	Agent - Casualty	8/22/2011	3/6/2020
Inactive	ACE American Insurance Company	300625	Agent - Health	8/24/2011	3/6/2020
Inactive	ACE American Insurance Company	300625	Agent - Property	8/22/2011	3/6/2020
Inactive	Aetna Health Inc.	300694	Agent - Health	5/14/2002	7/14/2003
Inactive	Aetna Life Insurance Company	301140	Agent - Health	4/15/2002	7/14/2003
Inactive	Aetna Life Insurance Company	301140	Agent - Life	4/15/2002	7/14/2003
Inactive	American Casualty Company of Reading, Pennsylvania	300956	Agent - Casualty	3/22/2016	3/6/2020
Inactive	American Casualty Company of Reading, Pennsylvania	300956	Agent - Property	3/22/2016	3/6/2020
Inactive	American Contractors Indemnity Company	536843	Agent - Casualty	12/5/2016	3/6/2020
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	10/19/2019	3/6/2020
Inactive	Anthem Life Insurance Company	301209	Agent - Health	10/19/2019	3/6/2020
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/19/2019	3/6/2020
Inactive	Arch Insurance Company	300688	Agent - Casualty	10/7/2011	1/16/2020
Inactive	Arch Insurance Company	300688	Agent - Property	10/7/2011	1/16/2020
Inactive	Berkley Insurance Company	301355	Agent - Casualty	8/24/2016	3/6/2020
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	4/18/2019	3/6/2020
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	4/18/2019	3/6/2020
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Casualty	1/4/2012	12/5/2013
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Property	1/4/2012	12/5/2013
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Health	6/21/2012	3/6/2020
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	6/21/2012	3/6/2020
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	8/15/2012	12/8/2015
Inactive	CompBenefits Insurance Company	301864	Agent - Health	8/15/2012	6/26/2013
Inactive	CompBenefits Insurance Company	301864	Agent - Life	8/15/2012	6/26/2013
Inactive	Continental Casualty Company	301019	Agent - Casualty	7/23/2018	3/6/2020
Inactive	Continental Casualty Company	301019	Agent - Property	7/23/2018	3/6/2020
Inactive	Continental Insurance Company (The)	301242	Agent - Casualty	11/20/2017	3/6/2020
Inactive	Continental Insurance Company (The)	301242	Agent - Property	11/20/2017	3/6/2020
Inactive	Contractors Bonding and Insurance Company	300184	Agent - Casualty	4/29/2019	2/10/2020
Inactive	Contractors Bonding and Insurance Company	300184	Agent - Property	4/29/2019	2/10/2020
Inactive	Dental Care Plus Inc.	301495	Agent - Health	7/9/2019	3/6/2020
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	8/15/2012	12/8/2015
Inactive	Employers Assurance Company	300120	Agent - Casualty	3/24/2014	3/6/2020
Inactive	Employers Compensation Insurance Company	797885	Agent - Casualty	8/6/2018	3/6/2020
Inactive	Employers Insurance Company of Wausau	301813	Agent - Casualty	8/21/2019	2/27/2020
Inactive	Employers Insurance Company of Wausau	301813	Agent - Property	8/21/2019	2/27/2020
Inactive	Employers Preferred Insurance Company	520656	Agent - Casualty	3/24/2014	3/6/2020
Inactive	Farmington Casualty Company	301137	Agent - Casualty	1/4/2012	12/5/2013
Inactive	Farmington Casualty Company	301137	Agent - Property	1/4/2012	12/5/2013
Inactive	Federal Insurance Company	301144	Agent - Casualty	2/19/2002	2/28/2003
Inactive	Federal Insurance Company	301144	Agent - Property	2/19/2002	2/28/2003
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - Casualty	10/17/2013	3/6/2020
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - Property	10/17/2013	3/6/2020
Inactive	First Liberty Insurance Corporation (The)	301060	Agent - Casualty	8/21/2019	2/27/2020
Inactive	First Liberty Insurance Corporation (The)	301060	Agent - Property	8/21/2019	2/27/2020
Inactive	General Casualty Company of Wisconsin	300930	Agent - Casualty	7/19/2018	3/6/2020
Inactive	General Casualty Company of Wisconsin	300930	Agent - Property	7/19/2018	3/6/2020
Inactive	Guarantee Company of North America USA (The)	300857	Agent - Casualty	9/14/2016	3/6/2020
Inactive	Guardian Insurance & Annuity Company Inc. (The)	301920	Agent - Life	4/18/2019	3/6/2020
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	4/18/2019	3/6/2020
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	4/18/2019	3/6/2020
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	8/15/2012	12/8/2015
Inactive	Humana Insurance Company	301104	Agent - Health	8/15/2012	12/8/2015
Inactive	Humana Insurance Company	301104	Agent - Life	8/15/2012	12/8/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	8/15/2012	12/8/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	8/15/2012	12/8/2015
Inactive	HumanaDental Insurance Company	301457	Agent - Health	6/17/2008	2/23/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	6/17/2008	2/23/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	11/5/2015	5/2/2017
Inactive	Kanawha Insurance Company	300127	Agent - Life	11/5/2015	5/2/2017
Inactive	LM Insurance Corporation	301061	Agent - Casualty	8/21/2019	2/27/2020
Inactive	LM Insurance Corporation	301061	Agent - Property	8/21/2019	2/27/2020
Inactive	Liberty Insurance Corporation	300444	Agent - Casualty	8/21/2019	2/27/2020
Inactive	Liberty Insurance Corporation	300444	Agent - Property	8/21/2019	2/27/2020
Inactive	Liberty Mutual Fire Insurance Company	301913	Agent - Casualty	8/21/2019	2/27/2020
Inactive	Liberty Mutual Fire Insurance Company	301913	Agent - Property	8/21/2019	2/27/2020
Inactive	Liberty Mutual Insurance Company	301159	Agent - Casualty	7/15/2015	2/27/2020
Inactive	Liberty Mutual Insurance Company	301159	Agent - Property	8/8/2018	2/27/2020
Inactive	Mount Vernon Fire Insurance Company	301397	Agent - Casualty	7/12/2013	1/9/2020
Inactive	Mount Vernon Fire Insurance Company	301397	Agent - Property	7/12/2013	1/9/2020
Inactive	North Pointe Insurance Company	301029	Agent - Casualty	7/19/2018	3/6/2020
Inactive	North Pointe Insurance Company	301029	Agent - Property	7/19/2018	3/6/2020
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	7/15/2015	2/27/2020
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	8/8/2018	2/27/2020
Inactive	Pie Insurance Company (The)	300514	Agent - Casualty	2/2/2001	2/28/2003
Inactive	Pie Insurance Company (The)	300514	Agent - Property	2/2/2001	2/28/2003
Inactive	Praetorian Insurance Company	301021	Agent - Casualty	7/19/2018	3/6/2020
Inactive	Praetorian Insurance Company	301021	Agent - Property	7/19/2018	3/6/2020
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	11/6/2009	1/27/2020
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	11/6/2009	1/27/2020
Inactive	QBE Insurance Corporation	300515	Agent - Casualty	7/19/2018	3/6/2020
Inactive	QBE Insurance Corporation	300515	Agent - Property	7/19/2018	3/6/2020
Inactive	RLI Insurance Company	301217	Agent - Casualty	8/22/2014	2/10/2020
Inactive	RLI Insurance Company	301217	Agent - Property	8/22/2014	2/10/2020
Inactive	Regent Insurance Company	300411	Agent - Casualty	7/19/2018	3/6/2020
Inactive	Regent Insurance Company	300411	Agent - Property	7/19/2018	3/6/2020
Inactive	Royal Insurance Company of America	301120	Agent - Casualty	11/27/2000	2/28/2003
Inactive	Royal Insurance Company of America	301120	Agent - Property	11/27/2000	2/28/2003
Inactive	Safety National Casualty Corporation	300390	Agent - Casualty	9/30/2013	3/6/2020
Inactive	Safety National Casualty Corporation	300390	Agent - Property	9/30/2013	3/6/2020
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - Casualty	1/4/2012	12/5/2013
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - Property	1/4/2012	12/5/2013
Inactive	St. Paul Guardian Insurance Company	301372	Agent - Casualty	1/4/2012	12/5/2013
Inactive	St. Paul Guardian Insurance Company	301372	Agent - Property	1/4/2012	12/5/2013
Inactive	St. Paul Mercury Insurance Company	300783	Agent - Casualty	1/4/2012	12/5/2013
Inactive	St. Paul Mercury Insurance Company	300783	Agent - Property	1/4/2012	12/5/2013
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Casualty	1/4/2012	12/5/2013
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Property	1/4/2012	12/5/2013
Inactive	Stonington Insurance Company	300746	Agent - Casualty	7/19/2018	3/6/2020
Inactive	Stonington Insurance Company	300746	Agent - Property	7/19/2018	3/6/2020
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	1/4/2012	12/5/2013
Inactive	The Phoenix Insurance Company	301502	Agent - Property	1/4/2012	12/5/2013
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Casualty	1/4/2012	12/5/2013
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Property	1/4/2012	12/5/2013
Inactive	Travelers Casualty and Surety Company	301067	Agent - Casualty	1/4/2012	3/6/2020
Inactive	Travelers Casualty and Surety Company	301067	Agent - Property	1/4/2012	3/6/2020
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	1/4/2012	12/3/2014
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	1/4/2012	12/3/2014
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	1/4/2012	12/3/2014
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	1/4/2012	12/3/2014
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Casualty	1/4/2012	12/5/2013
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Property	1/4/2012	12/5/2013
Inactive	Travelers Property Casualty Company of America	301649	Agent - Casualty	1/4/2012	3/6/2020
Inactive	Travelers Property Casualty Company of America	301649	Agent - Property	1/4/2012	3/6/2020
Inactive	U.S. Specialty Insurance Company	300186	Agent - Casualty	12/5/2016	3/6/2020
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	11/6/2009	1/27/2020
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	11/6/2009	1/27/2020
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	10/15/2017	3/6/2020
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	10/15/2017	3/6/2020
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	10/15/2017	3/6/2020
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	10/15/2017	4/30/2018
Inactive	Valley Forge Insurance Company	301052	Agent - Casualty	2/23/2016	12/11/2017
Inactive	Valley Forge Insurance Company	301052	Agent - Property	2/23/2016	12/11/2017
Inactive	Zurich American Insurance Company	301121	Agent - Casualty	10/17/2013	3/6/2020
Inactive	Zurich American Insurance Company	301121	Agent - Property	10/17/2013	3/6/2020

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bencomo, Rodolfo	895111	Agent - Casualty	6/19/2018	2/5/2019
Inactive	Bencomo, Rodolfo	895111	Agent - Property	6/19/2018	2/5/2019
Inactive	Bracy, James	1068349	Agent - Casualty	12/24/2019	3/6/2020
Inactive	Bracy, James	1068349	Agent - Property	12/24/2019	3/6/2020
Inactive	Brown, Jacob Benjamin	660337	Agent - Health	9/16/2011	5/13/2013
Inactive	Brown, Jacob Benjamin	660337	Agent - Life	9/16/2011	5/13/2013
Inactive	Cazares, Claudia Gabriela	866901	Agent - Casualty	10/26/2017	6/12/2018
Inactive	Cazares, Claudia Gabriela	866901	Agent - Health	10/26/2017	6/12/2018
Inactive	Cazares, Claudia Gabriela	866901	Agent - Life	10/26/2017	6/12/2018
Inactive	Cazares, Claudia Gabriela	866901	Agent - Property	10/26/2017	6/12/2018
Inactive	Conley, Shirley Ann	511890	Agent - Casualty	2/28/2003	2/28/2003
Inactive	Conley, Shirley Ann	511890	Agent - Property	2/28/2003	2/28/2003
Inactive	Coronado, Carlos Ivan	897574	Agent - Casualty	3/5/2018	3/9/2018
Inactive	Coronado, Carlos Ivan	897574	Agent - Property	3/5/2018	3/9/2018
Inactive	Crane, David Bernard	1032555	Agent - Casualty	4/15/2019	3/6/2020
Inactive	Crane, David Bernard	1032555	Agent - Property	4/15/2019	3/6/2020
Inactive	Cummings, Kevin Patrick	576103	Agent - Casualty	8/5/2011	10/14/2011
Inactive	Cummings, Kevin Patrick	576103	Agent - Property	8/5/2011	10/14/2011
Inactive	Decelles, Dawn Ella	704669	Agent - Health	12/9/2019	3/6/2020
Inactive	Decelles, Dawn Ella	704669	Agent - Life	12/9/2019	3/6/2020
Inactive	Duncan, Michael Robert Ryu	745710	Agent - Casualty	8/30/2017	3/6/2020
Inactive	Duncan, Michael Robert Ryu	745710	Agent - Property	8/30/2017	3/6/2020
Inactive	Eastman, Robin Elizabeth	997803	Agent - Casualty	7/27/2018	3/6/2020
Inactive	Eastman, Robin Elizabeth	997803	Agent - Property	7/27/2018	3/6/2020
Inactive	Eckard, Melinda Renae	1056588	Agent - Health	10/24/2019	3/6/2020
Inactive	Eckard, Melinda Renae	1056588	Agent - Life	10/24/2019	3/6/2020
Inactive	Fitzpatrick, Jonnalyn	909804	Agent - Casualty	9/14/2016	2/7/2018
Inactive	Fitzpatrick, Jonnalyn	909804	Agent - Property	9/14/2016	2/7/2018
Inactive	Garcia, Jennifer Serrano	673759	Agent - Casualty	10/12/2016	3/6/2020
Inactive	Garcia, Jennifer Serrano	673759	Agent - Property	10/12/2016	3/6/2020
Inactive	Garcia, Kristen Kathleen	744536	Agent - Casualty	8/24/2011	3/6/2020
Inactive	Garcia, Kristen Kathleen	744536	Agent - Property	8/24/2011	3/6/2020
Inactive	Gorman, Sarah Carolyn	672960	Agent - Casualty	12/20/2017	3/6/2020
Inactive	Gorman, Sarah Carolyn	672960	Agent - Property	12/20/2017	3/6/2020
Inactive	Grossman, Stephanie Diane	997512	Agent - Casualty	7/10/2018	3/6/2020
Inactive	Grossman, Stephanie Diane	997512	Agent - Property	7/10/2018	3/6/2020
Inactive	Herdrich, Darlene Gerene	744943	Agent - Casualty	5/13/2011	3/6/2020
Inactive	Herdrich, Darlene Gerene	744943	Agent - Property	5/13/2011	3/6/2020
Inactive	Herdrich, Darlene Gerene	744943	Surplus Lines Broker - Not Applicable	5/13/2011	7/8/2020
Inactive	Jensen, David Gardner	880271	Agent - Casualty	3/11/2016	3/6/2020
Inactive	Jensen, David Gardner	880271	Agent - Property	3/11/2016	3/6/2020
Inactive	Johnson, Nicole Pryde	960277	Agent - Casualty	4/22/2019	6/26/2019
Denied	Johnson, Nicole Pryde	960277	Agent - Health
Denied	Johnson, Nicole Pryde	960277	Agent - Life
Inactive	Johnson, Nicole Pryde	960277	Agent - Property	4/22/2019	6/26/2019
Inactive	Johnson, Philip Blake	803782	Agent - Casualty	10/23/2017	3/9/2018
Inactive	Johnson, Philip Blake	803782	Agent - Property	10/23/2017	3/9/2018
Denied	Jones, Tressa Sue	1041117	Agent - Health
Denied	Jones, Tressa Sue	1041117	Agent - Life
Inactive	Kissel, Sharla	1007590	Agent - Casualty	9/13/2018	3/6/2020
Inactive	Kissel, Sharla	1007590	Agent - Property	9/13/2018	3/6/2020
Inactive	Kissel, Sharla	1007590	Surplus Lines Broker - Not Applicable	1/16/2019	7/8/2020
Inactive	Leblanc, Paul Arthur	863195	Agent - Health	12/23/2014	3/9/2018
Inactive	Leblanc, Paul Arthur	863195	Agent - Life	12/23/2014	3/9/2018
Inactive	Matousek, Kerrin T	1014465	Agent - Health	11/6/2018	3/6/2020
Inactive	Matousek, Kerrin T	1014465	Agent - Life	11/6/2018	3/6/2020
Inactive	Mizell, Joanne Marie	701359	Agent - Health	5/9/2013	12/22/2014
Inactive	Mizell, Joanne Marie	701359	Agent - Life	5/9/2013	12/22/2014
Inactive	Peery, Denise Lynn	580605	Agent - Health	6/12/2008	6/30/2011
Inactive	Peery, Denise Lynn	580605	Agent - Life	6/12/2008	6/30/2011
Inactive	Poston, Christina Renee	1048023	Agent - Health	8/5/2019	3/6/2020
Inactive	Poston, Christina Renee	1048023	Agent - Life	8/5/2019	3/6/2020
Inactive	Ransom, Scherri	922237	Agent - Casualty	10/18/2017	3/6/2020
Inactive	Ransom, Scherri	922237	Agent - Property	10/18/2017	3/6/2020
Inactive	Sikon, Marisa	897650	Agent - Casualty	3/7/2019	3/6/2020
Inactive	Sikon, Marisa	897650	Agent - Property	3/7/2019	3/6/2020
Inactive	Simerman, Joshua Alan	981972	Agent - Health	5/10/2018	3/6/2020
Inactive	Simerman, Joshua Alan	981972	Agent - Life	5/10/2018	3/6/2020
Denied	Smith, Carolyn Rose	841146	Agent - Casualty
Denied	Smith, Carolyn Rose	841146	Agent - Property
Inactive	Sparkes, Shila Ann	891584	Agent - Casualty	2/7/2018	3/6/2020
Inactive	Sparkes, Shila Ann	891584	Agent - Health	2/15/2018	3/6/2020
Inactive	Sparkes, Shila Ann	891584	Agent - Life	2/15/2018	3/6/2020
Inactive	Sparkes, Shila Ann	891584	Agent - Property	2/7/2018	3/6/2020
Inactive	Spong, Pamela Sue	546665	Agent - Health	4/15/2002	7/14/2003
Inactive	Spong, Pamela Sue	546665	Agent - Life	4/15/2002	7/14/2003
Inactive	Thomas, Shaun Samuel	911499	Agent - Health	8/9/2018	3/6/2020
Inactive	Thomas, Shaun Samuel	911499	Agent - Life	8/9/2018	3/6/2020
Inactive	Thompson, Alicia Carol	744538	Agent - Casualty	5/13/2011	1/13/2017
Inactive	Thompson, Alicia Carol	744538	Agent - Property	5/13/2011	1/13/2017
Inactive	Thompson, Alicia Carol	744538	Surplus Lines Broker - Not Applicable	5/13/2011	8/18/2016
Inactive	Wagner, Kurt John	768587	Agent - Casualty	11/15/2011	2/27/2018
Inactive	Wagner, Kurt John	768587	Agent - Property	11/15/2011	2/27/2018
Inactive	Williams, Kaylin Marie	980756	Agent - Casualty	4/5/2019	3/6/2020
Inactive	Williams, Kaylin Marie	980756	Agent - Property	4/5/2019	3/6/2020
Inactive	Wilson, Theodore	936949	Agent - Casualty	5/9/2018	6/30/2019
Inactive	Wilson, Theodore	936949	Agent - Property	5/9/2018	6/30/2019