DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Douthat, Amber	DOIID	877548	NAIC NPN	17583991

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Denied	Resident	Agent	Life
Inactive	Resident	Agent	Health	6/9/2015	10/1/2017
* 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	Baptist Health Plan, Inc.	300157	Agent - Health	9/25/2015	10/1/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Baptist Health Plan, Inc. (TPA)	397874	Agent - Health	9/25/2015	6/13/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Health	9/25/2015	10/1/2017
Inactive	Medlink Inc	400721	Agent - Health	9/25/2015	12/8/2015