DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Mayo, Douglas P	DOIID	785508	NAIC NPN	14881240

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	7/6/2012	3/31/2015
Inactive	Non Resident	Agent	Health	7/6/2012	3/31/2015
* 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	9/11/2012	3/31/2015
Inactive	Aetna Life Insurance Company	301140	Agent - Health	9/11/2012	3/31/2015
Inactive	Aetna Life Insurance Company	301140	Agent - Life	9/11/2012	3/31/2015
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	8/22/2012	3/31/2015
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	8/22/2012	3/31/2015
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014	3/31/2015
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/10/2012	3/31/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	8/22/2012	3/31/2015
Inactive	Humana Insurance Company	301104	Agent - Health	8/21/2012	3/31/2015
Inactive	Humana Insurance Company	301104	Agent - Life	8/21/2012	3/31/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	8/22/2012	3/31/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	8/22/2012	3/31/2015
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/13/2014	3/31/2015
Inactive	Kanawha Insurance Company	300127	Agent - Health	6/11/2013	3/31/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	6/11/2013	3/31/2015
Inactive	Nassau Life Insurance Company of Kansas	300667	Agent - Health	9/14/2012	1/6/2014
Inactive	Renaissance Life & Health Insurance Company of America	301447	Agent - Health	1/16/2013	7/11/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bloom Insurance Agency LLC	664017	Agent - Life	10/22/2012	4/11/2014
Inactive	Bloom Insurance Agency LLC	664017	Agent - Health	10/22/2012	4/11/2014