DEPARTMENT OF INSURANCE
Affiliations
NameMullin Tbg Insurance Agency Services, LLCDOIID655561NAIC NPN8707321
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentLife6/21/2018 3/31/2025
ActiveNon ResidentAgentHealth6/21/2018 3/31/2025
DeniedNon ResidentAgentVariable Life and Variable Annuities   
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent01/15/202503/31/2025   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveEmpower Annuity Insurance Company300168Agent - Health12/9/20085/1/2018
ActiveEmpower Annuity Insurance Company300168Agent - Life11/16/2018 
InactiveEmpower Annuity Insurance Company300168Agent - Variable Life and Variable Annuities12/9/20085/1/2018
InactiveFortitude Life Insurance & Annuity Company301503Agent - Health12/4/20085/1/2018
ActiveFortitude Life Insurance & Annuity Company301503Agent - Life11/16/2018 
InactiveFortitude Life Insurance & Annuity Company301503Agent - Variable Life and Variable Annuities12/4/20085/1/2018
ActivePacific Life Insurance Company301848Agent - Health11/7/2018 
ActivePacific Life Insurance Company301848Agent - Life11/7/2018 
InactivePacific Life Insurance Company301848Agent - Variable Life and Variable Annuities5/21/20075/1/2018
InactiveProvident Life and Accident Insurance Company301525Agent - Health11/26/20079/9/2015
InactiveProvident Life and Accident Insurance Company301525Agent - Life11/26/20079/9/2015
InactivePrudential Insurance Company of America300784Agent - Health12/4/20085/1/2018
ActivePrudential Insurance Company of America300784Agent - Life11/16/2018 
InactivePrudential Insurance Company of America300784Agent - Variable Life and Variable Annuities12/4/20085/1/2018
InactiveUNUM Life Insurance Company of America300817Agent - Health11/26/20079/9/2015
InactiveUNUM Life Insurance Company of America300817Agent - Life11/26/20079/9/2015
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveBarens, Kristin Lucille 546190Agent - Health7/19/20121/14/2013
InactiveBarens, Kristin Lucille 546190Agent - Life7/19/20121/14/2013
InactiveBarens, Kristin Lucille 546190Agent - Variable Life and Variable Annuities7/19/20121/14/2013
InactiveBurlie, Jason Matthew 790389Agent - Health1/14/201311/19/2013
InactiveBurlie, Jason Matthew 790389Agent - Life1/14/201311/19/2013
InactiveBurlie, Jason Matthew 790389Agent - Variable Life and Variable Annuities1/14/201311/19/2013
InactiveClary, James M 388374Agent - Health5/17/20074/30/2010
InactiveClary, James M 388374Agent - Life5/17/20074/30/2010
InactiveClary, James M 388374Agent - Variable Life and Variable Annuities5/17/20074/30/2010
ActiveHickey, Nancy 965850Agent - Health6/21/2018 
ActiveHickey, Nancy 965850Agent - Life6/21/2018 
DeniedHickey, Nancy 965850Agent - Variable Life and Variable Annuities  
InactiveMcMahon, Deanna Bernice 323070Agent - Health7/16/20104/9/2012
InactiveMcMahon, Deanna Bernice 323070Agent - Life7/16/20104/9/2012
InactiveMcMahon, Deanna Bernice 323070Agent - Variable Life and Variable Annuities7/16/20104/9/2012
InactiveSegal, Kevin 810869Agent - Health11/18/20132/28/2018
InactiveSegal, Kevin 810869Agent - Life11/18/20132/28/2018
InactiveSegal, Kevin 810869Agent - Variable Life and Variable Annuities11/18/20132/28/2018

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