DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Krzemien, Leslie Diane	DOIID	654027	NAIC NPN	8269742

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	4/20/2007	7/5/2017
Inactive	Non Resident	Agent	Health	4/20/2007	7/5/2017
* 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	Colonial Life and Accident Insurance Company	300846	Agent - Health	4/2/2012	2/19/2014
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	4/2/2012	2/19/2014
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/19/2011	5/4/2017
Inactive	Kanawha Insurance Company	300127	Agent - Life	9/19/2011	5/4/2017
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	4/27/2007	3/10/2016
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	4/27/2007	3/10/2016
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	4/27/2007	3/10/2016
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	4/27/2007	3/10/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Willis Of Illinois Inc	398318	Agent - Health	9/27/2012	5/4/2017
Inactive	Willis Of Illinois Inc	398318	Agent - Life	9/27/2012	5/4/2017