DEPARTMENT OF INSURANCE

Affiliations

Name	Nickols, Sherry E	DOIID	511734	NAIC NPN	997516

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	3/17/2012	12/31/2015
Inactive	Non Resident	Agent	Health	3/17/2012	12/31/2015
* 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 Fidelity Assurance Company	301004	Agent - Health	10/30/2003	8/14/2006
Inactive	American Fidelity Assurance Company	301004	Agent - Life	10/30/2003	8/14/2006
Inactive	Anthem Life Insurance Company	301209	Agent - Health	6/28/2012	12/31/2015
Inactive	Anthem Life Insurance Company	301209	Agent - Life	6/28/2012	12/31/2015
Inactive	Assurity Life Insurance Company	301099	Agent - Health	12/18/2000	12/14/2006
Inactive	Assurity Life Insurance Company	301099	Agent - Life	12/18/2000	12/14/2006
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	9/10/2015	12/31/2015
Inactive	Conseco Health Insurance Company	301725	Agent - Health	9/14/2001	10/1/2010
Inactive	Conseco Health Insurance Company	301725	Agent - Life	9/14/2001	10/1/2010
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/10/2015	12/31/2015
Inactive	Golden Rule Insurance Company	301943	Agent - Health	4/2/2012	12/31/2015
Inactive	Golden Rule Insurance Company	301943	Agent - Life	4/2/2012	12/31/2015
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	6/13/2015	12/31/2015
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	6/13/2015	12/31/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	6/13/2015	12/31/2015
Inactive	Humana Insurance Company	301104	Agent - Health	6/13/2015	12/31/2015
Inactive	Humana Insurance Company	301104	Agent - Life	6/13/2015	12/31/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	6/13/2015	12/31/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	6/13/2015	12/31/2015
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	6/13/2015	12/31/2015
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/10/2015	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	9/10/2015	10/22/2015
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	11/8/2012	10/22/2013
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	5/21/2014	12/31/2015
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	5/21/2014	12/31/2015
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	4/9/2004	12/31/2011
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Life	4/9/2004	12/31/2011
Inactive	Pan-American Assurance Company	301533	Agent - Health	5/24/2002	4/8/2005
Inactive	Pan-American Assurance Company	301533	Agent - Life	5/24/2002	4/8/2005
Inactive	Pan-American Life Insurance Company	301530	Agent - Health	5/24/2002	4/8/2005
Inactive	Pan-American Life Insurance Company	301530	Agent - Life	5/24/2002	4/8/2005
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	4/9/2001	12/30/2009
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	4/9/2001	12/30/2009
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	5/30/2002	12/28/2011
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Life	5/30/2002	12/28/2011
Inactive	Time Insurance Company	300683	Agent - Health	5/15/2012	12/20/2014
Inactive	Time Insurance Company	300683	Agent - Life	5/15/2012	12/20/2014
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	4/9/2001	12/30/2009
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	4/9/2001	12/30/2009
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	11/8/2012	10/22/2013
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	11/8/2012	10/22/2013
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	11/12/2015	12/31/2015
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	11/12/2015	12/31/2015
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	8/18/2015	12/31/2015
Inactive	Washington National Insurance Company	300587	Agent - Health	10/1/2010	12/27/2010
Inactive	Washington National Insurance Company	300587	Agent - Life	10/1/2010	12/27/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	6/28/2012	12/31/2015
Inactive	Designated Agent Company Inc.	681257	Agent - Health	6/28/2012	12/31/2015