DEPARTMENT OF INSURANCE
Affiliations
NameEllis, Kaleb JDOIID768087NAIC NPN16451671
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveResidentAgentHealth11/15/20119/1/2014 
InactiveResidentAgentLife11/15/20119/1/2014 
* 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
InactiveAnthem Life Insurance Company301209Agent - Health11/23/20118/31/2014
InactiveAnthem Life Insurance Company301209Agent - Life11/23/20118/31/2014
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveDesignated Agent Company Inc.681257Agent - Life11/23/20119/25/2014
InactiveDesignated Agent Company Inc.681257Agent - Health11/23/20119/25/2014
InactiveSynergy Insurance Agency, Inc.694265Agent - Life11/23/20113/31/2014
InactiveSynergy Insurance Agency, Inc.694265Agent - Health11/23/20113/31/2014

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