DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Shadburne, Kathryn Blythe	DOIID	685418	NAIC NPN	11165315

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	9/26/2008	1/1/2014
Inactive	Resident	Agent	Health	9/26/2008	1/1/2014
* 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	Anthem Life Insurance Company	301209	Agent - Health	1/2/2009	1/1/2014
Inactive	Anthem Life Insurance Company	301209	Agent - Life	1/2/2009	1/1/2014
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	6/12/2009	7/10/2013
Inactive	CompBenefits Insurance Company	301864	Agent - Health	6/12/2009	12/12/2011
Inactive	CompBenefits Insurance Company	301864	Agent - Life	6/12/2009	12/12/2011
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	5/13/2010	7/10/2013
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/5/2009	7/10/2013
Inactive	Humana Insurance Company	301104	Agent - Health	3/5/2009	7/10/2013
Inactive	Humana Insurance Company	301104	Agent - Life	3/5/2009	7/10/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	3/5/2009	7/10/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	3/5/2009	7/10/2013
Inactive	HumanaDental Insurance Company	301457	Agent - Health	6/12/2009	2/23/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	6/12/2009	2/23/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	3/5/2009	4/25/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	3/5/2009	4/25/2013

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	1/2/2009	5/31/2011
Inactive	FSAB, LLC	576450	Agent - Life	1/2/2009	5/31/2011
Inactive	USI Midwest LLC	517736	Agent - Health	8/12/2011	7/2/2012
Inactive	USI Midwest LLC	517736	Agent - Life	8/12/2011	7/2/2012