DEPARTMENT OF INSURANCE

Affiliations

Name	Purdom, Matthew	DOIID	870224	NAIC NPN	17516133

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	3/10/2015	11/1/2017
Inactive	Resident	Agent	Life	3/13/2015	11/1/2017
* 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 Continental Insurance Company	643130	Agent - Life	7/7/2015	12/15/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Health	3/18/2015	11/1/2017
Inactive	Anthem Life Insurance Company	301209	Agent - Life	3/18/2015	11/1/2017
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	10/12/2017	11/1/2017
Inactive	Bankers Fidelity Assurance Company	554627	Agent - Health	2/8/2017	12/5/2017
Inactive	Bankers Fidelity Assurance Company	554627	Agent - Life	2/8/2017	12/5/2017
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Health	3/23/2015	12/5/2017
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Life	3/23/2015	12/5/2017
Inactive	Banner Life Insurance Company	301696	Agent - Life	6/30/2015	11/1/2017
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	3/23/2015	12/8/2015
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/23/2015	12/8/2015
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	3/23/2015	11/1/2017
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	3/23/2015	11/1/2017
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/23/2015	11/1/2017
Inactive	Humana Insurance Company	301104	Agent - Health	3/23/2015	11/1/2017
Inactive	Humana Insurance Company	301104	Agent - Life	3/23/2015	11/1/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	3/23/2015	11/1/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	3/23/2015	11/1/2017
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	3/23/2015	11/1/2017
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	11/1/2017
Inactive	Kanawha Insurance Company	300127	Agent - Health	3/23/2015	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	3/23/2015	10/22/2015

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	3/18/2015	11/1/2017
Inactive	Designated Agent Company Inc.	681257	Agent - Health	3/18/2015	11/1/2017