DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Kelly, Tally Larange	DOIID	792865	NAIC NPN	16711013

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	1/31/2015
* 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	UnitedHealthcare Insurance Company	300946	Agent - Health	9/28/2012	12/20/2012
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	9/28/2012	12/20/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Alorica Customer Care, Inc.	800938	Agent - Health