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DEPARTMENT OF INSURANCE
Affiliations
Name
Ellis, Kaleb J
DOIID
768087
NAIC NPN
16451671
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Inactive
Resident
Agent
Health
11/15/2011
9/1/2014
Inactive
Resident
Agent
Life
11/15/2011
9/1/2014
* 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
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Anthem Life Insurance Company
301209
Agent - Health
11/23/2011
8/31/2014
Inactive
Anthem Life Insurance Company
301209
Agent - Life
11/23/2011
8/31/2014
Designated to act on behalf of the following Business Entities
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Designated Agent Company Inc.
681257
Agent - Life
11/23/2011
9/25/2014
Inactive
Designated Agent Company Inc.
681257
Agent - Health
11/23/2011
9/25/2014
Inactive
Synergy Insurance Agency, Inc.
694265
Agent - Life
11/23/2011
3/31/2014
Inactive
Synergy Insurance Agency, Inc.
694265
Agent - Health
11/23/2011
3/31/2014
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