DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Nelson, Michele H	DOIID	829120	NAIC NPN	3535120

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	12/7/2013	11/30/2016
Inactive	Non Resident	Agent	Health	12/7/2013	11/30/2016
Inactive	Non Resident	Independent Adjuster	Property & Casualty	12/5/2019	11/30/2022
* 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	Anthem Life Insurance Company	301209	Agent - Health	12/20/2013	11/30/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	12/20/2013	11/30/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/20/2013	11/30/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/20/2013	11/30/2016