DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Henderson, Renee S	DOIID	589046	NAIC NPN	2191531

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	5/7/2004	6/30/2006
Inactive	Non Resident	Agent	Life	5/7/2004	6/30/2006
* 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	Anthem Life Insurance Company	301209	Agent - Health	6/28/2004	6/30/2006
Inactive	Anthem Life Insurance Company	301209	Agent - Life	6/28/2004	6/30/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CBISA Reaquisitian Corp	547026	Agent - Life	6/28/2004	6/30/2006
Inactive	CBISA Reaquisitian Corp	547026	Agent - Health	6/28/2004	6/30/2006