DEPARTMENT OF INSURANCE
Affiliations
NameUnited Capital Risk Management LLCDOIID739083NAIC NPN15907756
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentHealth2/13/20243/31/2024 
InactiveNon ResidentAgentLife2/13/20243/31/2024 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAetna Health and Life Insurance Company300523Agent - Health7/3/20181/3/2024
InactiveAllianz Life Insurance Company of North America301791Agent - Life3/7/20191/3/2024
InactiveAmerican Continental Insurance Company643130Agent - Life7/3/20188/11/2021
InactiveBanner Life Insurance Company301696Agent - Life5/12/20161/3/2024
InactiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Health7/3/20181/3/2024
InactiveMidland National Life Insurance Company300923Agent - Life12/7/20161/3/2024
InactivePruco Life Insurance Company300954Agent - Life2/15/20243/31/2024
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveBackora, Richard William 837912Agent - Health4/30/20162/13/2017
InactiveBackora, Richard William 837912Agent - Life4/30/20162/13/2017
InactiveCass, David M 562627Agent - Health1/16/20204/27/2022
InactiveCass, David M 562627Agent - Life1/16/20204/27/2022
InactiveFritz, Robert F 1221260Agent - Health10/12/20221/3/2024
InactiveFritz, Robert F 1221260Agent - Life10/12/20221/3/2024
InactiveKelly, Heather Lynn 900397Agent - Health2/15/20171/16/2020
InactiveKelly, Heather Lynn 900397Agent - Life2/15/20171/16/2020
DeniedLatini, Gregory 905282Agent - Health  
DeniedLatini, Gregory 905282Agent - Life  
DeniedMcdonald, Thomas K 960371Agent - Health  
DeniedMcdonald, Thomas K 960371Agent - Life  
InactiveRivers, James Francis 1304398Agent - Health2/13/20243/31/2024
InactiveRivers, James Francis 1304398Agent - Life2/13/20243/31/2024
DeniedRoller, Ryan 1026327Agent - Health  
InactiveRoller, Ryan 1026327Agent - Life2/12/201912/20/2023
InactiveSlafsky, Neal Aaron 736924Agent - Health10/7/20104/21/2014
InactiveSlafsky, Neal Aaron 736924Agent - Life10/7/20104/21/2014
InactiveSnyder, Christian 1116326Agent - Health4/1/20221/11/2023
InactiveSnyder, Christian 1116326Agent - Life4/1/20221/11/2023
InactiveSurenkamp, Raymond Michael 565337Agent - Life5/2/201812/20/2021
DeniedWeatherly, Brian Robert 1028880Agent - Health  
DeniedWeatherly, Brian Robert 1028880Agent - Life  
DeniedWolfe, Robert Brian 749436Agent - Health  
DeniedWolfe, Robert Brian 749436Agent - Life  

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