DEPARTMENT OF INSURANCE

Affiliations

Name	Theiss, Mary Donna	DOIID	611888	NAIC NPN	8518292

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Casualty	1/14/2022	10/31/2025
Active	Resident	Agent	Life	1/14/2022	10/31/2025
Active	Resident	Agent	Health	1/14/2022	10/31/2025
Active	Resident	Agent	Property	1/14/2022	10/31/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	08/15/2025	10/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Economy Insurance Company	300315	Agent - Casualty	10/10/2024
Active	American Economy Insurance Company	300315	Agent - Property	10/10/2024
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	10/7/2008	10/31/2019
Inactive	American Fire and Casualty Company	300567	Agent - Property	10/7/2008	10/31/2019
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Health	2/22/2006	10/31/2019
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Life	2/22/2006	10/31/2019
Inactive	Anthem Life Insurance Company	301209	Agent - Health	5/20/2009	10/31/2019
Inactive	Anthem Life Insurance Company	301209	Agent - Life	5/20/2009	10/31/2019
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	10/7/2008	10/31/2019
Inactive	Consolidated Insurance Company	300943	Agent - Property	10/7/2008	10/31/2019
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	12/4/2009
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	1/19/2006	12/4/2009
Inactive	Humana Insurance Company	301104	Agent - Health	1/19/2006	12/4/2009
Inactive	Humana Insurance Company	301104	Agent - Life	1/19/2006	12/4/2009
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	1/19/2006	12/4/2009
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	1/19/2006	12/4/2009
Inactive	Indiana Insurance Company	301909	Agent - Casualty	10/7/2008	10/31/2019
Inactive	Indiana Insurance Company	301909	Agent - Property	10/7/2008	10/31/2019
Inactive	Nationwide Assurance Company	300166	Agent - Casualty	7/27/2005	10/31/2019
Inactive	Nationwide General Insurance Company	300603	Agent - Casualty	7/27/2005	10/31/2019
Inactive	Nationwide General Insurance Company	300603	Agent - Property	7/27/2005	10/31/2019
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	7/17/2024	12/18/2024
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	7/17/2024	12/18/2024
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Health	7/17/2024	12/18/2024
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	7/17/2024	12/18/2024
Inactive	Nationwide Mutual Fire Insurance Company	301722	Agent - Casualty	7/27/2005	10/31/2019
Inactive	Nationwide Mutual Fire Insurance Company	301722	Agent - Property	7/27/2005	10/31/2019
Active	Nationwide Mutual Insurance Company	301749	Agent - Casualty	2/21/2024
Active	Nationwide Mutual Insurance Company	301749	Agent - Property	2/21/2024
Inactive	Nationwide Property and Casualty Insurance Company	300599	Agent - Casualty	7/27/2005	10/31/2019
Inactive	Nationwide Property and Casualty Insurance Company	300599	Agent - Property	7/27/2005	10/31/2019
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	10/7/2008	10/31/2019
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	10/7/2008	10/31/2019
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	10/7/2008	10/31/2019
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	10/7/2008	10/31/2019
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	10/7/2008	10/31/2019
Inactive	Ohio Security Insurance Company	300622	Agent - Property	10/7/2008	10/31/2019
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	10/7/2008	10/31/2019
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	10/7/2008	10/31/2019
Inactive	Peerless Insurance Company	301910	Agent - Casualty	10/7/2008	10/31/2019
Inactive	Peerless Insurance Company	301910	Agent - Property	10/7/2008	10/31/2019
Active	Progressive Casualty Insurance Company	300696	Agent - Casualty	10/28/2024
Active	Progressive Casualty Insurance Company	300696	Agent - Property	10/28/2024
Active	SAFECO Insurance Company of America	300159	Agent - Casualty	4/12/2024
Active	SAFECO Insurance Company of America	300159	Agent - Property	4/12/2024
Active	United Financial Casualty Company	301886	Agent - Casualty	10/28/2024
Active	United Financial Casualty Company	301886	Agent - Property	10/28/2024
Inactive	Victoria Fire & Casualty Company	300313	Agent - Casualty	2/12/2007	10/16/2017
Inactive	Victoria Fire & Casualty Company	300313	Agent - Property	2/12/2007	10/16/2017
Inactive	West American Insurance Company	301112	Agent - Casualty	10/7/2008	10/31/2019
Inactive	West American Insurance Company	301112	Agent - Property	10/7/2008	10/31/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Health	5/20/2009	10/31/2019
Inactive	Designated Agent Company Inc.	681257	Agent - Life	5/20/2009	10/31/2019
Active	Donnie R Kays Ins Inc	398073	Agent - Casualty	2/21/2024
Active	Donnie R Kays Ins Inc	398073	Agent - Health	12/18/2024
Active	Donnie R Kays Ins Inc	398073	Agent - Life	12/18/2024
Active	Donnie R Kays Ins Inc	398073	Agent - Property	2/21/2024
Inactive	LocalEdge Insurance Agency, Inc.	515576	Agent - Casualty	12/17/2008	10/31/2019
Inactive	LocalEdge Insurance Agency, Inc.	515576	Agent - Property	12/17/2008	10/31/2019