DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Mumford, Lisa Michelle	DOIID	664007	NAIC NPN	9676504

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	10/12/2007	9/1/2009
Inactive	Resident	Agent	Life	10/12/2007	9/1/2009
* 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	Connecticut General Life Insurance Company	301333	Agent - Health	10/27/2008	9/1/2009
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	11/8/2007	9/1/2009
Inactive	Humana Insurance Company	301104	Agent - Health	11/8/2007	9/1/2009
Inactive	Humana Insurance Company	301104	Agent - Life	11/8/2007	9/1/2009
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	11/8/2007	9/1/2009
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	11/8/2007	9/1/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	FSAB, LLC	576450	Agent - Health	11/8/2007	9/1/2009
Inactive	FSAB, LLC	576450	Agent - Life	11/8/2007	9/1/2009