DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Summit America Insurance Services, LC	DOIID	566410	NAIC NPN	964071

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Denied	Non Resident	Agent	Casualty
Denied	Non Resident	Agent	Property
Inactive	Non Resident	Agent	Health	8/8/2005	3/31/2013
Inactive	Non Resident	Agent	Life	9/1/2005	3/31/2013
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	8/13/2009	3/31/2013
Inactive	Aetna Life Insurance Company	301140	Agent - Health	8/13/2009	3/31/2013
Inactive	Aetna Life Insurance Company	301140	Agent - Life	8/13/2009	3/31/2013
Inactive	Combined Insurance Company of America	301472	Agent - Health	9/2/2005	3/31/2013
Inactive	Fairmont Premier Insurance Company	300892	Agent - Health	8/23/2005	10/16/2006
Inactive	Gulf Insurance Company	300761	Agent - Casualty	4/28/2003	4/5/2004
Inactive	Gulf Insurance Company	300761	Agent - Property	4/28/2003	4/5/2004
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	9/8/2005	3/31/2013
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	12/28/2012	3/31/2013
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	1/16/2009	5/30/2012
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	1/16/2009	5/30/2012
Inactive	North River Insurance Company (The)	301739	Agent - Health	5/2/2006	3/31/2013
Inactive	United States Fire Insurance Company	582240	Agent - Health	5/2/2006	3/31/2013

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Briggs, Janice Marie	637635	Agent - Health
Denied	Briggs, Janice Marie	637635	Agent - Life
Denied	Gagnon, Lesley King	565335	Agent - Health
Denied	Gagnon, Lesley King	565335	Agent - Life
Denied	Mayo, Paul Phillip	349587	Agent - Casualty
Inactive	Mayo, Paul Phillip	349587	Agent - Health	8/8/2005	3/31/2013
Inactive	Mayo, Paul Phillip	349587	Agent - Life	9/1/2005	3/31/2013
Denied	Mayo, Paul Phillip	349587	Agent - Property
Denied	Stanek, Krista	623601	Agent - Health