DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Professional Brokerage Inc	DOIID	644315	NAIC NPN	2109244

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Administrator	Not Applicable	8/19/2008	3/31/2012
Inactive	Non Resident	Agent	Health	5/5/2022	3/31/2024
Inactive	Non Resident	Agent	Life	5/5/2022	3/31/2024
Inactive	Non Resident	Life & Health Consultant	Not Applicable	8/19/2008	8/6/2009
* 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

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	All Savers Insurance Company	301940	Agent - Health	5/16/2022	5/31/2024
Inactive	All Savers Insurance Company	301940	Agent - Life	5/16/2022	5/31/2024
Inactive	Companion Life Insurance Company	300191	Agent - Health	8/10/2009	3/31/2012
Inactive	Companion Life Insurance Company	300191	Agent - Life	8/10/2009	3/31/2012
Inactive	HCC Life Insurance Company	301827	Agent - Health	2/16/2009	12/3/2010
Inactive	HCC Life Insurance Company	301827	Agent - Life	2/16/2009	12/3/2010
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	5/10/2022	5/31/2024
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	5/10/2022	5/31/2024
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	5/10/2022	5/31/2024
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Life	5/10/2022	3/31/2024
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	5/10/2022	5/31/2024
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Life	5/10/2022	3/31/2024

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Burke, Deborah	711115	Administrator - Not Applicable	9/15/2009	12/7/2009
Inactive	Childers, Frank Randall	390690	Administrator - Not Applicable	8/19/2008	9/4/2009
Inactive	Childers, Frank Randall	390690	Agent - Health	9/8/2008	9/4/2009
Inactive	Childers, Frank Randall	390690	Agent - Life	9/8/2008	9/4/2009
Inactive	Childers, Frank Randall	390690	Life & Health Consultant - Not Applicable	8/19/2008	8/6/2009
Inactive	Demarco, Frank J	686405	Agent - Health	5/5/2022	3/31/2024
Inactive	Demarco, Frank J	686405	Agent - Life	5/5/2022	3/31/2024
Inactive	Jones, Jody	526854	Administrator - Not Applicable	9/15/2009	3/31/2012
Inactive	Mason, Deedra	711122	Administrator - Not Applicable	9/15/2009	12/7/2009
Inactive	McDonald, Barbara Jean	537149	Administrator - Not Applicable	8/17/2009	8/31/2009
Inactive	Wentworth, Patricia	711123	Administrator - Not Applicable	9/15/2009	3/31/2012
Inactive	Williams, Mildred	711274	Administrator - Not Applicable	9/15/2009	12/7/2009