DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Lincoln Ins Services	DOIID	749714	NAIC NPN	2744092

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	3/10/2011	3/31/2019
Inactive	Non Resident	Agent	Life	3/10/2011	3/31/2019
Denied	Non Resident	Life & Health Consultant	Not Applicable
* 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	UnitedHealthcare Insurance Company	300946	Agent - Health	3/30/2017	5/31/2019
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	3/30/2017	5/31/2019
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	3/30/2017	5/31/2019
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	3/30/2017	4/30/2018

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dalziel, Douglas Collin	616613	Agent - Health	3/10/2011	3/31/2019
Inactive	Dalziel, Douglas Collin	616613	Agent - Life	3/10/2011	3/31/2019