DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Willoughby-Ray, Sean R	DOIID	721221	NAIC NPN	2971530

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	1/27/2010	1/13/2023
Inactive	Non Resident	Agent	Life	1/27/2010	1/13/2023
* 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	Baptist Health Plan, Inc.	300157	Agent - Health	3/17/2010	3/31/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	5/7/2010	3/31/2019
Inactive	James A Scott & Son Inc	509408	Agent - Health	3/17/2010	3/31/2019
Denied	James A Scott & Son Inc	509408	Agent - Life