DEPARTMENT OF INSURANCE

Affiliations

Name	Cetera Advisors Ins Services LLC	DOIID	814192	NAIC NPN	662600

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	7/31/2013	3/31/2025
Active	Non Resident	Agent	Health	7/31/2013	3/31/2025
Active	Non Resident	Agent	Variable Life and Variable Annuities	7/31/2013	3/31/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	01/15/2025	03/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Allianz Life Insurance Company of North America	301791	Agent - Health	4/4/2017
Active	Allianz Life Insurance Company of North America	301791	Agent - Life	4/4/2017
Active	Allianz Life Insurance Company of North America	301791	Agent - Variable Life and Variable Annuities	4/4/2017
Active	American General Life Insurance Company	301585	Agent - Life	10/27/2022
Active	American General Life Insurance Company	301585	Agent - Variable Life and Variable Annuities	10/27/2022
Active	Ameritas Life Insurance Corporation	300126	Agent - Life	11/8/2022
Active	Ameritas Life Insurance Corporation	300126	Agent - Variable Life and Variable Annuities	11/8/2022
Active	Eagle Life Insurance Company	701261	Agent - Life	10/8/2015
Active	Fortitude Life Insurance & Annuity Company	301503	Agent - Life	6/10/2019
Active	Fortitude Life Insurance & Annuity Company	301503	Agent - Variable Life and Variable Annuities	6/10/2019
Active	Jackson National Life Insurance Company	300486	Agent - Life	1/31/2019
Active	Jackson National Life Insurance Company	300486	Agent - Variable Life and Variable Annuities	1/31/2019
Active	Midland National Life Insurance Company	300923	Agent - Life	4/21/2019
Active	North American Company for Life and Health Insurance	300291	Agent - Life	4/21/2019
Active	Pruco Life Insurance Company	300954	Agent - Life	6/10/2019
Active	Pruco Life Insurance Company	300954	Agent - Variable Life and Variable Annuities	6/10/2019

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Macumber, Mark Albert	785689	Agent - Health		10/24/2013
Inactive	Macumber, Mark Albert	785689	Agent - Life		10/24/2013
Inactive	Macumber, Mark Albert	785689	Agent - Variable Life and Variable Annuities		10/24/2013
Active	Smiley, Stanley Robert	575944	Agent - Health	7/31/2013
Active	Smiley, Stanley Robert	575944	Agent - Life	7/31/2013
Active	Smiley, Stanley Robert	575944	Agent - Variable Life and Variable Annuities	7/31/2013
Inactive	Tawney, Amanda Lee	755270	Agent - Health	12/12/2013	12/15/2014
Inactive	Tawney, Amanda Lee	755270	Agent - Life	12/12/2013	12/15/2014
Inactive	Tawney, Amanda Lee	755270	Agent - Variable Life and Variable Annuities	12/12/2013	12/15/2014