DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Fuller, Latoya S	DOIID	792812	NAIC NPN	16336582

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	9/28/2012	6/30/2014
Pending Replacement	Non Resident	Agent	Property	10/28/2021		6/30/2024
Pending Replacement	Non Resident	Agent	Casualty	10/28/2021		6/30/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	04/15/2024	06/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	National General Insurance Company	300152	Agent - Casualty	11/2/2021	12/17/2021
Inactive	National General Insurance Company	300152	Agent - Property	11/2/2021	12/17/2021
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	3/14/2013	6/30/2014
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	3/14/2013	6/30/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Affinity Brokerage, LLC	544886	Agent - Casualty	11/10/2021	12/17/2021
Inactive	Affinity Brokerage, LLC	544886	Agent - Property	11/10/2021	12/17/2021
Inactive	CWI, LLC	662170	Agent - Casualty	11/10/2021	12/17/2021
Inactive	CWI, LLC	662170	Agent - Property	11/10/2021	12/17/2021
Inactive	Camping World Insurance Services of Kentucky, LLC	663187	Agent - Casualty	11/10/2021	12/17/2021
Inactive	Camping World Insurance Services of Kentucky, LLC	663187	Agent - Property	11/10/2021	12/17/2021
Inactive	Direct General Insurance Agency Inc	1018980	Agent - Casualty	11/10/2021	12/17/2021
Inactive	Direct General Insurance Agency Inc	1018980	Agent - Property	11/10/2021	12/17/2021
Inactive	National General Ins Marketing Inc	621228	Agent - Casualty	11/10/2021	12/17/2021
Inactive	National General Ins Marketing Inc	621228	Agent - Property	11/10/2021	12/17/2021