DEPARTMENT OF INSURANCE

Affiliations

Name	CBC Insurance Revenue Securitization, LLC	DOIID	563273	NAIC NPN	7371933

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	7/3/2003	3/31/2025
Active	Non Resident	Agent	Life	7/3/2003	3/31/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	01/15/2025	03/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	C.M. Life Insurance Company	301335	Agent - Health	11/18/2003	11/16/2012
Inactive	C.M. Life Insurance Company	301335	Agent - Life	11/18/2003	11/16/2012
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	7/23/2003	12/30/2009
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	7/23/2003	12/30/2009
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	9/19/2008	8/31/2018
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	9/19/2008	8/31/2018
Inactive	John Hancock Variable Life Insurance Company	301914	Agent - Life	7/23/2003	2/23/2009
Inactive	Life Investors Insurance Company of America	301793	Agent - Health	7/3/2003	9/24/2008
Inactive	Life Investors Insurance Company of America	301793	Agent - Life	7/3/2003	6/19/2008
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Health	5/15/2006	11/16/2012
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Life	5/15/2006	11/16/2012
Active	Nationwide Life Insurance Company	300495	Agent - Health	3/30/2017
Active	Nationwide Life Insurance Company	300495	Agent - Life	3/30/2017
Active	Nationwide Life and Annuity Insurance Company	300714	Agent - Health	3/31/2017
Active	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	3/31/2017
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Health	1/23/2004	10/2/2005
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Life	1/23/2004	10/2/2005
Inactive	Transamerica Assurance Company	300893	Agent - Health	7/17/2003	10/1/2004
Inactive	Transamerica Assurance Company	300893	Agent - Life	7/17/2003	10/1/2004
Active	Transamerica Life Insurance Company	300571	Agent - Health	10/1/2004
Active	Transamerica Life Insurance Company	300571	Agent - Life	7/22/2003
Inactive	Western Reserve Life Assurance Company of Ohio	300760	Agent - Life	7/22/2003	6/20/2008

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Ballou, Kevin	522771	Agent - Health	5/5/2010	9/30/2012
Inactive	Ballou, Kevin	522771	Agent - Life	5/5/2010	9/30/2012
Inactive	Cook, Traci	721883	Agent - Health	3/24/2011	2/3/2017
Inactive	Cook, Traci	721883	Agent - Life	3/24/2011	2/3/2017
Active	Cox, Joanna B	673862	Agent - Health	1/20/2017
Active	Cox, Joanna B	673862	Agent - Life	1/20/2017
Inactive	Huerta, Carlos Alberto	602003	Agent - Health	4/12/2007	5/5/2010
Inactive	Huerta, Carlos Alberto	602003	Agent - Life	4/12/2007	5/5/2010
Inactive	Parker, Christopher Lee	524223	Agent - Health	4/12/2007	4/12/2007
Inactive	Parker, Christopher Lee	524223	Agent - Life	4/12/2007	4/12/2007