DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Pioneer Interstate Marketing Corp	DOIID	651840	NAIC NPN	3196996

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	5/11/2007	3/31/2021
Inactive	Non Resident	Agent	Life	5/11/2007	3/31/2021
* 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	Athene Annuity & Life Assurance Company	301798	Agent - Life	6/24/2013	8/13/2015
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	2/10/2012	9/3/2013
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	9/3/2013
Inactive	HCC Life Insurance Company	301827	Agent - Health	3/5/2017	7/11/2017
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	1/30/2008	9/3/2013
Inactive	Humana Insurance Company	301104	Agent - Health	1/30/2008	9/3/2013
Inactive	Humana Insurance Company	301104	Agent - Life	1/30/2008	9/3/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	1/30/2008	9/3/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	1/30/2008	9/3/2013
Inactive	HumanaDental Insurance Company	301457	Agent - Health	1/30/2008	2/23/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	1/30/2008	2/23/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	2/10/2012	4/25/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	2/10/2012	4/25/2013
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	6/5/2007	12/26/2012
Inactive	Omaha Insurance Company	751908	Agent - Health	12/27/2012	12/23/2013
Inactive	United World Life Insurance Company	300532	Agent - Health	6/5/2007	12/15/2010
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	6/5/2007	12/26/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	6/5/2007	12/26/2012

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Douglas, Allan S	651527	Agent - Health	5/11/2007	3/31/2021
Inactive	Douglas, Allan S	651527	Agent - Life	5/11/2007	3/31/2021
Inactive	Fricke, Kurtis Raymond	634641	Agent - Health	5/11/2007	3/31/2021
Inactive	Fricke, Kurtis Raymond	634641	Agent - Life	5/11/2007	3/31/2021