DEPARTMENT OF INSURANCE

Affiliations

Name	The Life and Annuity Shop, LLC	DOIID	712024	NAIC NPN	13880030

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	8/24/2009	3/31/2025
Active	Non Resident	Agent	Life	8/24/2009	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	AmFirst Insurance Company	999525	Agent - Life	5/31/2024
Active	American Equity Investment Life Insurance Company	300389	Agent - Life	5/20/2010
Inactive	American General Life Insurance Company	301585	Agent - Health	7/3/2011	11/9/2012
Active	American General Life Insurance Company	301585	Agent - Life	7/28/2014
Active	American Life & Security Corp	1055058	Agent - Life	7/14/2023
Inactive	American National Insurance Company	301861	Agent - Health	5/21/2010	6/11/2021
Active	American National Insurance Company	301861	Agent - Life	5/21/2010
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Health	7/20/2016	10/3/2023
Active	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	5/9/2014
Active	Atlantic Coast Life Insurance Company	642114	Agent - Life	7/30/2016
Inactive	Bankers Life Insurance Company	301784	Agent - Life	9/30/2013	2/8/2019
Active	Clear Spring Life and Annuity Company	300919	Agent - Life	6/11/2021
Active	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	10/13/2011
Active	Forethought Life Insurance Company	301407	Agent - Life	11/11/2009
Active	Fortitude Life Insurance & Annuity Company	301503	Agent - Life	6/4/2020
Inactive	Genworth Life Insurance Company	300623	Agent - Health	4/29/2010	10/4/2012
Inactive	Genworth Life Insurance Company	300623	Agent - Life	4/29/2010	10/4/2012
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Health	4/29/2010	10/4/2012
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	4/29/2010	10/4/2012
Active	Gerber Life Insurance Company	300529	Agent - Health	6/11/2013
Active	Gerber Life Insurance Company	300529	Agent - Life	6/11/2013
Active	Integrity Life Insurance Company	301687	Agent - Life	9/15/2009
Active	Investors Heritage Life Insurance Company	300363	Agent - Life	10/5/2018
Active	LifeShield National Insurance Company	737111	Agent - Life	2/20/2020
Inactive	Lincoln Benefit Life Company	301110	Agent - Health	5/25/2010	7/14/2014
Inactive	Lincoln Benefit Life Company	301110	Agent - Life	5/25/2010	7/14/2014
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Health	6/17/2010
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Life	6/17/2010
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	5/27/2010	1/27/2014
Inactive	Nassau Life and Annuity Company	513671	Agent - Life	4/15/2019	11/30/2021
Active	National Security Insurance Company	1282495	Agent - Life	1/19/2024
Active	National Western Life Insurance Company	301515	Agent - Life	2/21/2011
Active	Nationwide Life Insurance Company	300495	Agent - Health	4/11/2024
Active	Nationwide Life Insurance Company	300495	Agent - Life	4/11/2024
Active	Nationwide Life and Annuity Insurance Company	300714	Agent - Health	1/19/2021
Active	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	1/19/2021
Active	Oceanview Life and Annuity Company	301868	Agent - Life	2/4/2020
Active	Ohio State Life Insurance Company (The)	300865	Agent - Life	10/11/2022
Inactive	Omaha Insurance Company	751908	Agent - Health	3/30/2012	1/27/2014
Inactive	PHL Variable Insurance Company	300525	Agent - Life	9/23/2014	12/4/2020
Active	Pacific Guardian Life Insurance Co., Ltd.	1074040	Agent - Life	6/7/2022
Active	Protective Life Insurance Company	300638	Agent - Life	10/11/2011
Active	Pruco Life Insurance Company	300954	Agent - Life	4/7/2022
Active	Royal Neighbors of America	301646	Agent - Life	1/23/2015
Inactive	SILAC Insurance Company	300535	Agent - Health	10/10/2012	9/23/2013
Active	SILAC Insurance Company	300535	Agent - Life	3/28/2019
Active	Sentinel Security Life Insurance Company	935789	Agent - Health	2/14/2018
Active	Sentinel Security Life Insurance Company	935789	Agent - Life	2/14/2018
Active	Talcott Resolution Life Insurance Company	301759	Agent - Health	5/21/2010
Active	Talcott Resolution Life Insurance Company	301759	Agent - Life	5/21/2010
Active	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Health	5/21/2010
Active	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Life	5/21/2010
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	5/27/2010	1/27/2014
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	5/27/2010	1/27/2014
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	10/5/2011	11/19/2014
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	10/5/2011	11/19/2014
Inactive	West Coast Life Insurance Company	301607	Agent - Health	5/28/2010	11/16/2011
Inactive	West Coast Life Insurance Company	301607	Agent - Life	5/28/2010	11/16/2011

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Graham, Mark Burnside	638756	Agent - Health	4/13/2018	9/22/2022
Inactive	Graham, Mark Burnside	638756	Agent - Life	4/13/2018	9/22/2022
Inactive	North, Timothy Owen	514133	Agent - Health	8/24/2009	4/13/2018
Inactive	North, Timothy Owen	514133	Agent - Life	8/24/2009	4/13/2018
Pending	Sheen, Andrew	1292171	Agent - Health
Active	Sheen, Andrew	1292171	Agent - Life	7/3/2024
Active	Sipes, Janet Leigh	658658	Agent - Health	9/22/2022
Active	Sipes, Janet Leigh	658658	Agent - Life	9/22/2022