PUBLIC PROTECTION
CABINET
DEPARTMENT OF INSURANCE
Affiliations
NameTillman, John (Jack) CharlesDOIID599517NAIC NPN3698609
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveResidentAdministratorNot Applicable2/5/200710/31/2009 
InactiveResidentAgentLife12/22/200411/1/2009 
InactiveResidentAgentHealth12/22/200411/1/2009 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveUnitedHealthcare Insurance Company300946Agent - Health12/22/200411/3/2009
InactiveUnitedHealthcare Insurance Company300946Agent - Life12/22/200411/3/2009
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health2/11/200511/3/2009
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health2/11/200511/3/2009
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveUnited Healthcare Services Inc.397284Administrator - Not Applicable10/1/200810/31/2009

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