DEPARTMENT OF INSURANCE

Affiliations

Name	Tiburon Insurance Services	DOIID	654167	NAIC NPN	9038483

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	2/6/2019	3/31/2025
Active	Non Resident	Agent	Life	5/4/2007	3/31/2025
Active	Non Resident	Agent	Casualty	2/6/2019	3/31/2025
Active	Non Resident	Agent	Health	5/4/2007	3/31/2025
* 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	01/15/2025	03/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Aetna Health Inc. (PA)	660717	Agent - Health	9/12/2018
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/24/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	9/12/2018
Active	Aetna Life Insurance Company	301140	Agent - Life	9/12/2018
Inactive	American Economy Insurance Company	300315	Agent - Casualty	3/23/2022	3/29/2024
Inactive	American Economy Insurance Company	300315	Agent - Property	3/23/2022	3/29/2024
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	7/29/2019
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	7/29/2019
Active	First Health Life & Health Insurance Company	301735	Agent - Health	9/12/2018
Inactive	Globe Life and Accident Insurance Company	300639	Agent - Health	5/22/2007	5/18/2010
Inactive	Globe Life and Accident Insurance Company	300639	Agent - Life	5/22/2007	5/18/2010
Inactive	Pruco Life Insurance Company	300954	Agent - Health	5/24/2007	9/12/2008
Active	Pruco Life Insurance Company	300954	Agent - Life	7/13/2018
Active	SilverScript Insurance Company	663526	Agent - Health	8/23/2019
Active	Standard Fire Insurance Company (The)	301068	Agent - Casualty	7/4/2019
Active	Standard Fire Insurance Company (The)	301068	Agent - Property	7/4/2019
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	5/25/2021	11/16/2023
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	5/25/2021	11/16/2023
Active	Travelers Personal Insurance Company	705785	Agent - Casualty	3/22/2019
Active	Travelers Personal Insurance Company	705785	Agent - Property	3/22/2019
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	5/18/2017	7/1/2020
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	5/18/2017	12/20/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	8/5/2019	7/1/2020
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	7/15/2018	7/1/2020
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	5/18/2017	7/1/2020
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	2/12/2019	5/13/2021

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Atkinson, Jill	895000	Agent - Health	7/29/2016	4/30/2017
Inactive	Atkinson, Jill	895000	Agent - Life	7/29/2016	4/30/2017
Inactive	Augst, Alan Robert	520679	Agent - Health	5/16/2007	1/4/2016
Inactive	Augst, Alan Robert	520679	Agent - Life	5/16/2007	1/4/2016
Active	Barwick, Kody	1016209	Agent - Casualty	2/7/2019
Active	Barwick, Kody	1016209	Agent - Health	6/4/2019
Active	Barwick, Kody	1016209	Agent - Property	2/7/2019
Inactive	Beall, Marc Andrew	536375	Agent - Health	6/8/2007	11/30/2013
Inactive	Beall, Marc Andrew	536375	Agent - Life	6/8/2007	11/30/2013
Inactive	Blake, Amanda Page	917755	Agent - Health	7/29/2016	9/25/2020
Inactive	Blake, Amanda Page	917755	Agent - Life	7/29/2016	9/25/2020
Inactive	Blue, Sarahlynn	1012492	Agent - Casualty	2/7/2019	7/22/2020
Inactive	Blue, Sarahlynn	1012492	Agent - Property	2/7/2019	7/22/2020
Active	Booth, Shirelle	540466	Agent - Health	7/9/2018
Active	Booth, Shirelle	540466	Agent - Life	7/9/2018
Inactive	Brown, Kevin W	306796	Agent - Health	7/29/2016	7/31/2022
Inactive	Brown, Kevin W	306796	Agent - Life	7/29/2016	7/31/2022
Inactive	Burton, Aaron William	577568	Agent - Health	5/16/2007	9/7/2010
Inactive	Burton, Aaron William	577568	Agent - Life	5/16/2007	9/7/2010
Inactive	Castillo, Jessica L	894174	Agent - Health	8/5/2016	5/31/2020
Inactive	Castillo, Jessica L	894174	Agent - Life	8/5/2016	5/31/2020
Inactive	Cooper, Heather	895038	Agent - Health	7/29/2016	9/17/2019
Inactive	Denatale, Michael	1016162	Agent - Casualty	2/7/2019	6/25/2019
Inactive	Denatale, Michael	1016162	Agent - Property	2/7/2019	6/25/2019
Active	Desturler, Shannan Kelly	865461	Agent - Health	7/29/2016
Active	Desturler, Shannan Kelly	865461	Agent - Life	7/29/2016
Active	Durham, Morgan Gentry	856157	Agent - Health	7/29/2016
Active	Durham, Morgan Gentry	856157	Agent - Life	7/29/2016
Inactive	Esler, Kelly Marie	906139	Agent - Health	7/9/2018	6/30/2022
Inactive	Esler, Kelly Marie	906139	Agent - Life	7/9/2018	6/30/2022
Inactive	Facklam, Karen Maria	825480	Agent - Health	8/5/2016	2/1/2022
Inactive	Facklam, Karen Maria	825480	Agent - Life	8/5/2016	1/14/2022
Inactive	Gorius, Michael	844991	Agent - Casualty	2/7/2019	5/31/2021
Inactive	Gorius, Michael	844991	Agent - Property	2/7/2019	5/31/2021
Active	Grant, Robert Clay	748109	Agent - Health	11/14/2018
Active	Grant, Robert Clay	748109	Agent - Life	11/14/2018
Inactive	Hebler, Erik Douglas	586938	Agent - Health	5/16/2007	10/31/2023
Inactive	Hebler, Erik Douglas	586938	Agent - Life	5/16/2007	10/31/2023
Inactive	Hibbs, Gerald Leon	1014584	Agent - Casualty	2/7/2019	5/31/2022
Inactive	Hibbs, Gerald Leon	1014584	Agent - Property	2/7/2019	5/31/2022
Inactive	Hudnall, Barry Joseph	895011	Agent - Health	7/29/2016	10/31/2020
Inactive	Hudnall, Barry Joseph	895011	Agent - Life	7/29/2016	10/31/2020
Inactive	Huntley, Phillip A	830905	Agent - Health	7/29/2016	5/31/2021
Inactive	Huntley, Phillip A	830905	Agent - Life	7/29/2016	5/31/2021
Active	Jackson, Jariane L	865466	Agent - Health	7/29/2016
Active	Jackson, Jariane L	865466	Agent - Life	7/29/2016
Inactive	Johnson, Perez M	865465	Agent - Health	8/5/2016	8/29/2016
Inactive	Johnson, Perez M	865465	Agent - Life	8/5/2016	8/29/2016
Active	Jones, Regina Rene	772807	Agent - Health	8/5/2016
Active	Jones, Regina Rene	772807	Agent - Life	8/5/2016
Active	Juarez, Maria	822110	Agent - Health	8/5/2016
Active	Juarez, Maria	822110	Agent - Life	8/5/2016
Active	Kirkpatrick, Cole	865489	Agent - Health	7/29/2016
Active	Kirkpatrick, Cole	865489	Agent - Life	7/29/2016
Inactive	Kuestersteffen, Gary	840532	Agent - Health	7/29/2016	9/20/2022
Inactive	Kuestersteffen, Gary	840532	Agent - Life	7/29/2016	9/20/2022
Inactive	Lewis, Ryan	884821	Agent - Health	7/29/2016	1/31/2022
Inactive	Lewis, Ryan	884821	Agent - Life	7/29/2016	1/31/2022
Inactive	Lombardi, Jonathan J	927305	Agent - Health	7/9/2018	9/30/2019
Inactive	Lombardi, Jonathan J	927305	Agent - Life	7/9/2018	9/30/2019
Active	Lynn, Patrick Joseph	894143	Agent - Health	3/23/2018
Active	Lynn, Patrick Joseph	894143	Agent - Life	3/23/2018
Active	McDaniel, Henry Keith	818197	Agent - Casualty	8/23/2023
Active	McDaniel, Henry Keith	818197	Agent - Property	8/23/2023
Active	Mcdonough, Brianna	894187	Agent - Health	8/5/2016
Active	Mcdonough, Brianna	894187	Agent - Life	8/5/2016
Inactive	Mcfield, Shay Lynn	927344	Agent - Health	3/23/2018	4/30/2024
Inactive	Mcfield, Shay Lynn	927344	Agent - Life	3/23/2018	4/30/2024
Inactive	Mcknight, Matthew Mills	639758	Agent - Health	5/16/2007	2/8/2008
Inactive	Mcknight, Matthew Mills	639758	Agent - Life	5/16/2007	2/8/2008
Inactive	Newhouse, Shirley L	865468	Agent - Health	7/29/2016	3/31/2019
Inactive	Newhouse, Shirley L	865468	Agent - Life	7/29/2016	3/31/2019
Inactive	O'Dowd, Melissa Nicole	845939	Agent - Casualty	2/6/2019	8/23/2023
Inactive	O'Dowd, Melissa Nicole	845939	Agent - Property	2/6/2019	8/23/2023
Inactive	Padgett, Nicholas A	831036	Agent - Health	7/9/2018	2/18/2020
Inactive	Padgett, Nicholas A	831036	Agent - Life	7/9/2018	2/18/2020
Inactive	Payne, Zachary R	865469	Agent - Health	7/29/2016	12/31/2022
Inactive	Payne, Zachary R	865469	Agent - Life	7/29/2016	12/31/2022
Inactive	Perry, Michael B	830821	Agent - Health	7/29/2016	9/30/2018
Inactive	Perry, Michael B	830821	Agent - Life	7/29/2016	9/30/2018
Inactive	Pringle, Randy J	1016025	Agent - Casualty	6/4/2019	6/25/2019
Inactive	Pringle, Randy J	1016025	Agent - Property	6/4/2019	6/25/2019
Active	Qefalia, Erjola	911882	Agent - Health	2/17/2020
Active	Qefalia, Erjola	911882	Agent - Life	2/17/2020
Inactive	Richardson, Sirryan G	927362	Agent - Health	7/9/2018	2/18/2020
Inactive	Richardson, Sirryan G	927362	Agent - Life	7/9/2018	2/18/2020
Inactive	Rynearson, Bradley K	932103	Agent - Casualty	6/4/2019	9/5/2019
Inactive	Rynearson, Bradley K	932103	Agent - Property	6/4/2019	9/5/2019
Inactive	Schmalz, David	761496	Agent - Health	7/29/2016	3/31/2019
Inactive	Schmalz, David	761496	Agent - Life	7/29/2016	3/31/2019
Active	Shapiro, Benjamin Ernest	969226	Agent - Health	2/17/2020
Active	Shapiro, Benjamin Ernest	969226	Agent - Life	2/17/2020
Inactive	Singh, Charan Jit	334930	Agent - Health	5/4/2007	12/31/2020
Inactive	Singh, Charan Jit	334930	Agent - Life	5/4/2007	12/31/2020
Active	Singleton, Richard N	894190	Agent - Health	7/9/2018
Active	Singleton, Richard N	894190	Agent - Life	7/9/2018
Inactive	Thomas, Brian Patrick	990782	Agent - Health	7/9/2018	3/31/2022
Inactive	Thomas, Brian Patrick	990782	Agent - Life	7/9/2018	3/31/2022
Inactive	Waybright, Adam Marvin	1000138	Agent - Casualty	2/7/2019	12/31/2023
Inactive	Waybright, Adam Marvin	1000138	Agent - Property	2/7/2019	12/31/2023
Inactive	Williams, Frank	1012562	Agent - Casualty	2/7/2019	11/30/2021
Inactive	Williams, Frank	1012562	Agent - Property	2/7/2019	11/30/2021
Active	Woodruff, Michael Joe	830976	Agent - Health	7/9/2018
Active	Woodruff, Michael Joe	830976	Agent - Life	7/9/2018