DEPARTMENT OF INSURANCE

Affiliations

Name	Wallace, Teresa Ann	DOIID	761221	NAIC NPN	16350402

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Life	7/10/2020	5/1/2024
Inactive	Resident	Agent	Property	7/10/2020	5/1/2024
Inactive	Resident	Agent	Health	7/10/2020	5/1/2024
Inactive	Resident	Agent	Casualty	7/10/2020	5/1/2024
Denied	Resident	Independent Adjuster	Property & Casualty
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	12/1/2020	4/3/2023
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	12/1/2020	4/4/2023
Inactive	Aetna Life Insurance Company	301140	Agent - Health	12/1/2020	4/3/2023
Inactive	Allstate Indemnity Company	300778	Agent - Casualty	7/30/2020	9/16/2020
Inactive	Allstate Indemnity Company	300778	Agent - Property	7/30/2020	9/16/2020
Inactive	Allstate Insurance Company	300773	Agent - Casualty	7/30/2020	9/16/2020
Inactive	Allstate Insurance Company	300773	Agent - Property	7/30/2020	9/16/2020
Inactive	Allstate Property and Casualty Insurance Company	300593	Agent - Casualty	7/30/2020	9/16/2020
Inactive	Allstate Property and Casualty Insurance Company	300593	Agent - Property	7/30/2020	9/16/2020
Inactive	Allstate Vehicle & Property Insurance Company	301429	Agent - Casualty	7/30/2020	9/16/2020
Inactive	Allstate Vehicle & Property Insurance Company	301429	Agent - Property	7/30/2020	9/16/2020
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	10/26/2015	4/13/2018
Inactive	American Fire and Casualty Company	300567	Agent - Property	10/26/2015	4/13/2018
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	11/8/2020	5/14/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Health	11/8/2020	5/14/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/8/2020	5/14/2021
Inactive	Banner Life Insurance Company	301696	Agent - Life	4/1/2015	9/5/2017
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	11/9/2011	9/22/2015
Inactive	Bristol West Insurance Company	301655	Agent - Property	11/9/2011	9/22/2015
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	11/7/2011	7/10/2013
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	10/26/2015	4/13/2018
Inactive	Consolidated Insurance Company	300943	Agent - Property	10/26/2015	4/13/2018
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	11/7/2011	7/10/2013
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	10/26/2011	9/22/2015
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	10/26/2011	9/22/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	11/7/2011	7/10/2013
Inactive	Humana Insurance Company	301104	Agent - Health	11/7/2011	7/10/2013
Inactive	Humana Insurance Company	301104	Agent - Life	11/7/2011	7/10/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	11/7/2011	7/10/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	11/7/2011	7/10/2013
Inactive	HumanaDental Insurance Company	301457	Agent - Health	11/7/2011	2/23/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	11/7/2011	2/23/2012
Inactive	Indiana Insurance Company	301909	Agent - Casualty	10/26/2015	4/13/2018
Inactive	Indiana Insurance Company	301909	Agent - Property	10/26/2015	4/13/2018
Inactive	Kanawha Insurance Company	300127	Agent - Health	11/7/2011	4/25/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	11/7/2011	4/25/2013
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	10/26/2015	4/13/2018
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	10/26/2015	4/13/2018
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	10/26/2015	4/13/2018
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	10/26/2015	4/13/2018
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	10/26/2015	4/13/2018
Inactive	Ohio Security Insurance Company	300622	Agent - Property	10/26/2015	4/13/2018
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	10/26/2015	4/13/2018
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	10/26/2015	4/13/2018
Inactive	Peerless Insurance Company	301910	Agent - Casualty	10/26/2015	4/13/2018
Inactive	Peerless Insurance Company	301910	Agent - Property	10/26/2015	4/13/2018
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	12/21/2011	4/8/2015
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	12/21/2011	4/8/2015
Inactive	Progressive Northern Insurance Company	301378	Agent - Casualty	12/21/2011	4/8/2015
Inactive	Progressive Northern Insurance Company	301378	Agent - Property	12/21/2011	4/8/2015
Inactive	Shelter General Insurance Company	301109	Agent - Casualty	9/16/2011	1/17/2015
Inactive	Shelter General Insurance Company	301109	Agent - Property	9/16/2011	1/17/2015
Inactive	Shelter Life Insurance Company	300391	Agent - Health	9/16/2011	1/17/2015
Inactive	Shelter Life Insurance Company	300391	Agent - Life	9/16/2011	1/17/2015
Inactive	Shelter Mutual Insurance Company	301870	Agent - Casualty	9/16/2011	1/17/2015
Inactive	Shelter Mutual Insurance Company	301870	Agent - Property	9/16/2011	1/17/2015
Inactive	SilverScript Insurance Company	663526	Agent - Health	12/1/2020	4/3/2023
Inactive	United Financial Casualty Company	301886	Agent - Casualty	12/21/2011	4/8/2015
Inactive	United Financial Casualty Company	301886	Agent - Property	12/21/2011	4/8/2015
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	10/21/2015	8/22/2016
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	10/21/2015	8/22/2016
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	12/19/2020	12/30/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	12/19/2020	12/31/2021
Inactive	West American Insurance Company	301112	Agent - Casualty	10/26/2015	4/13/2018
Inactive	West American Insurance Company	301112	Agent - Property	10/26/2015	4/13/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Gateway Ins Marketing Inc	613567	Agent - Life	2/2/2012	1/17/2015
Inactive	Gateway Ins Marketing Inc	613567	Agent - Health	2/2/2012	1/17/2015
Inactive	Insuramax Inc	400061	Agent - Casualty	2/4/2015	5/4/2015
Inactive	Insuramax Inc	400061	Agent - Property	2/4/2015	5/4/2015
Inactive	Insuramax Inc	400061	Agent - Life	4/1/2015	5/4/2015
Denied	Insuramax Inc	400061	Agent - Health