DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Ray, Kansas Dawn	DOIID	623303	NAIC NPN	8685065

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	1/17/2006		3/31/2025
Active	Resident	Agent	Life	1/17/2006		3/31/2025
* 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
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	1/17/2006
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	1/17/2006
Active	Cincinnati Life Insurance Company (The)	300601	Agent - Life	11/8/2018
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Health	9/30/2020	2/13/2024
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	9/30/2020	2/13/2024
Active	Combined Insurance Company of America	301472	Agent - Health	10/25/2018
Active	Combined Insurance Company of America	301472	Agent - Life	10/25/2018
Active	Continental American Insurance Company	301700	Agent - Health	11/15/2010
Active	Continental American Insurance Company	301700	Agent - Life	11/15/2010
Inactive	Protective Life Insurance Company	300638	Agent - Health	1/17/2021	11/23/2023
Inactive	Protective Life Insurance Company	300638	Agent - Life	1/17/2021	11/23/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Hollandstivers Employer Solutions LLC	1073922	Agent - Health	1/6/2021	8/30/2022
Inactive	Hollandstivers Employer Solutions LLC	1073922	Agent - Life	1/6/2021	8/30/2022