PUBLIC PROTECTION
CABINET
DEPARTMENT OF INSURANCE
Affiliations
NameHealth Source One Insurance Group, LLCDOIID787497NAIC NPN16735053
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentHealth9/21/20123/31/2016 
InactiveNon ResidentAgentLife9/21/20123/31/2016 
* 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
InactiveCompanion Life Insurance Company300191Agent - Health3/6/20133/31/2016
InactiveCompanion Life Insurance Company300191Agent - Life3/6/20133/31/2016
InactiveFreedom Life Insurance Company of America300074Agent - Health1/11/20136/4/2014
InactiveFreedom Life Insurance Company of America300074Agent - Life1/11/20136/4/2014
InactiveStarr Indemnity and Liability Company301685Agent - Health3/11/20133/31/2016
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveBoodram, Andrew 785255Agent - Health10/26/20122/27/2014
InactiveBoodram, Andrew 785255Agent - Life10/26/20122/27/2014
InactiveByrnes, Robert Jeff 389998Agent - Health9/21/20123/31/2016
InactiveByrnes, Robert Jeff 389998Agent - Life9/21/20123/31/2016
InactiveDernier, Rachel 786139Agent - Health2/13/20134/4/2013
InactiveDernier, Rachel 786139Agent - Life2/13/20134/4/2013
InactiveDezile, Allen 785238Agent - Health9/21/20122/13/2013
InactiveDezile, Allen 785238Agent - Life9/21/20122/13/2013
InactiveEulo, James 785258Agent - Health10/26/20122/27/2014
InactiveEulo, James 785258Agent - Life10/26/20122/27/2014
InactiveHarris, Carlos 786137Agent - Health2/14/20132/27/2014
InactiveHarris, Carlos 786137Agent - Life2/14/20132/27/2014
InactiveHurley, Jill J 785677Agent - Health10/26/20122/27/2014
InactiveHurley, Jill J 785677Agent - Life10/26/20122/27/2014
InactiveJalil, Jimmy R 745688Agent - Health9/21/20122/27/2014
InactiveJalil, Jimmy R 745688Agent - Life10/18/20122/27/2014
InactiveLandry, Jennifer Lynn 794652Agent - Health7/5/20132/27/2014
InactiveLandry, Jennifer Lynn 794652Agent - Life7/5/20132/27/2014
DeniedMcfadden, Whitney Nicole 786298Agent - Health  
DeniedMcfadden, Whitney Nicole 786298Agent - Life  
InactiveValdez, Alex Alberto 786142Agent - Health10/26/20122/13/2013
InactiveValdez, Alex Alberto 786142Agent - Life10/26/20122/13/2013
InactiveWilliams, Bryana Malica 786966Agent - Health10/26/20122/13/2013
InactiveWilliams, Bryana Malica 786966Agent - Life10/26/20122/13/2013

© Commonwealth of Kentucky. All rights reserved.