DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Sullivan, Keith Bryant	DOIID	525198	NAIC NPN	585986

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Administrator	Not Applicable	7/19/2001	8/12/2019
Inactive	Non Resident	Agent	Life	3/25/2011	8/12/2019
Inactive	Non Resident	Agent	Health	3/25/2011	8/12/2019
* 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	Provident Life and Accident Insurance Company	301525	Agent - Health	4/6/2011	9/9/2015
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	4/6/2011	9/9/2015
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	7/25/2016	8/12/2019
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	7/25/2016	8/12/2019
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	4/6/2011	9/9/2015
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	4/6/2011	9/9/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Armada Administrators LLC	928685	Administrator - Not Applicable	9/30/2016	8/12/2019
Inactive	Armada Corp	827705	Administrator - Not Applicable	11/15/2013	8/12/2019
Inactive	Armadacare LLC	918919	Agent - Health	6/21/2016	5/18/2017
Inactive	Armadacare LLC	918919	Agent - Life	6/21/2016	5/18/2017
Inactive	Performax Inc	524975	Administrator - Not Applicable	7/19/2001	5/23/2008