DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	F B P Ins Services LLC	DOIID	568596	NAIC NPN	686890

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Denied	Non Resident	Administrator	Not Applicable
Inactive	Non Resident	Agent	Health	10/3/2012	5/21/2019
Inactive	Non Resident	Agent	Life	10/3/2012	5/21/2019
* 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	Colonial Life and Accident Insurance Company	300846	Agent - Health	10/18/2013	5/21/2019
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	10/18/2013	5/21/2019
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	10/5/2012	5/21/2019
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	10/5/2012	5/21/2019
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	10/5/2012	5/21/2019
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	10/5/2012	5/21/2019

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Burmeister, Angela Rochelle	816011	Agent - Health
Denied	Burmeister, Angela Rochelle	816011	Agent - Life
Inactive	Jurenka, Jonathan Andrew	906364	Agent - Life	2/10/2016	5/21/2019
Inactive	Olson, Wade Robert	571728	Agent - Health	10/3/2012	6/7/2018
Inactive	Olson, Wade Robert	571728	Agent - Life	10/3/2012	6/7/2018
Inactive	Swinnerton, Matthew Carl	979306	Agent - Health	9/12/2018	5/21/2019
Denied	Swinnerton, Matthew Carl	979306	Agent - Life