DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Carriss, Mary Beth	DOIID	843657	NAIC NPN	17300032

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Limited Line Credit	9/1/2016		5/31/2026
Denied	Resident	Agent	Health
Denied	Resident	Agent	Life
* 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	American Health and Life Insurance Company	300844	Agent - Limited Line Credit	7/26/2019	6/11/2024
Active	Lyndon Southern Insurance Company	609602	Agent - Limited Line Credit	7/2/2024
Active	Southern Financial Life Insurance Company	300664	Agent - Limited Line Credit	7/2/2024
Inactive	Triton Insurance Company	300654	Agent - Limited Line Credit	7/26/2019	6/11/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Onemain Assurance Services LLC	751094	Agent - Limited Line Credit	7/26/2019	6/11/2024