DEPARTMENT OF INSURANCE

Affiliations

Name	O'Brien, Justin Mangrum	DOIID	674362	NAIC NPN	10321210

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Life	3/27/2008	11/1/2017
Inactive	Resident	Agent	Property	3/27/2008	11/1/2017
Inactive	Resident	Agent	Casualty	3/27/2008	11/1/2017
Inactive	Resident	Agent	Health	3/27/2008	11/1/2017
* 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	American Interstate Insurance Company	301092	Agent - Casualty	12/9/2013	3/17/2015
Inactive	American Interstate Insurance Company	301092	Agent - Property	12/9/2013	3/17/2015
Inactive	Anthem Life Insurance Company	301209	Agent - Health	3/3/2011	6/19/2017
Inactive	Anthem Life Insurance Company	301209	Agent - Life	3/3/2011	6/19/2017
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	3/22/2013	12/5/2014
Inactive	Curative Insurance Company of Illinois	535026	Agent - Casualty	6/28/2011	11/1/2017
Inactive	Curative Insurance Company of Illinois	535026	Agent - Property	6/28/2011	11/17/2011
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/22/2013	12/5/2014
Inactive	FFVA Mutual Insurance Company	552456	Agent - Casualty	2/1/2013	6/23/2015
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Casualty	5/9/2014	1/23/2015
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Property	5/9/2014	1/23/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/22/2013	4/13/2015
Inactive	Humana Insurance Company	301104	Agent - Health	11/20/2012	4/13/2015
Inactive	Humana Insurance Company	301104	Agent - Life	11/20/2012	4/13/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	3/22/2013	12/5/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	3/22/2013	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Health	3/22/2013	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	3/22/2013	12/5/2014
Inactive	Motorists Commercial Mutual Insurance Company	301941	Agent - Casualty	10/26/2012	7/15/2015
Inactive	Motorists Commercial Mutual Insurance Company	301941	Agent - Property	10/26/2012	7/15/2015
Inactive	Motorists Mutual Insurance Company	300963	Agent - Casualty	10/26/2012	7/15/2015
Inactive	Motorists Mutual Insurance Company	300963	Agent - Property	10/26/2012	7/15/2015
Inactive	Old Republic General Insurance Corporation	300949	Agent - Casualty	11/20/2013	2/12/2015
Inactive	Old Republic Insurance Company	301225	Agent - Casualty	10/1/2013	2/12/2015
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	7/6/2011	2/6/2013
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	7/6/2011	2/6/2013
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	3/6/2013	11/1/2017
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	3/6/2013	11/1/2017
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	3/6/2013	11/1/2017
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	3/6/2013	11/1/2017
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Casualty	12/18/2012	1/23/2015
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Property	12/18/2012	1/23/2015
Inactive	State Farm Fire and Casualty Company	301809	Agent - Casualty	3/27/2008	2/17/2011
Inactive	State Farm Fire and Casualty Company	301809	Agent - Property	3/27/2008	2/17/2011
Inactive	State Farm General Insurance Company	301122	Agent - Casualty	3/27/2008	11/17/2010
Inactive	State Farm General Insurance Company	301122	Agent - Property	3/27/2008	11/17/2010
Inactive	State Farm Life Insurance Company	301810	Agent - Life	3/27/2008	2/17/2011
Inactive	State Farm Mutual Automobile Insurance Company	301732	Agent - Casualty	3/27/2008	2/17/2011
Inactive	State Farm Mutual Automobile Insurance Company	301732	Agent - Health	3/27/2008	2/17/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Anchor Insurance Agency Inc.	398530	Agent - Property	8/20/2013	7/28/2015
Inactive	Anchor Insurance Agency Inc.	398530	Agent - Casualty	8/20/2013	7/28/2015
Inactive	Anchor Insurance Agency Inc.	398530	Agent - Life	8/20/2013	7/28/2015
Inactive	Anchor Insurance Agency Inc.	398530	Agent - Health	8/20/2013	7/28/2015
Inactive	Kiely Hines & Associates Insurance Agency Inc.	399757	Agent - Property	6/28/2011	8/20/2012
Inactive	Kiely Hines & Associates Insurance Agency Inc.	399757	Agent - Casualty	6/28/2011	8/20/2012
Inactive	Kiely Hines & Associates Insurance Agency Inc.	399757	Agent - Life	3/15/2011	8/20/2012
Inactive	Kiely Hines & Associates Insurance Agency Inc.	399757	Agent - Health	3/15/2011	8/20/2012