DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Gershuny, Keri L	DOIID	591542	NAIC NPN	4777434

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Administrator	Not Applicable	10/16/2006	11/30/2010
Inactive	Non Resident	Agent	Life	6/24/2004	11/15/2010
Inactive	Non Resident	Agent	Health	6/24/2004	11/15/2010
* 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	New York Life Insurance Company	300431	Agent - Health	7/13/2004	7/27/2009
Inactive	New York Life Insurance Company	300431	Agent - Life	7/13/2004	7/27/2009
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Health	11/9/2004	11/15/2010
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Life	11/9/2004	11/15/2010
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	11/15/2005	11/15/2010
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	11/15/2005	11/15/2010
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	11/15/2005	11/15/2010
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	11/15/2005	11/15/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bertholon-Rowland Corp	394872	Agent - Health	8/16/2004	3/31/2009
Inactive	Bertholon-Rowland Corp	394872	Agent - Life	8/16/2004	3/31/2009
Inactive	Bertholon-Rowland Corp	394872	Administrator - Not Applicable	12/27/2006	11/30/2010