DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Simmons, Blake	DOIID	883657	NAIC NPN	17652806

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	3/3/2016	12/1/2018
Inactive	Resident	Agent	Health	3/3/2016	12/1/2018
* 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	8/30/2016	2/6/2018
Inactive	Anthem Life Insurance Company	301209	Agent - Life	8/30/2016	2/6/2018

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	8/30/2016	2/5/2018
Inactive	Designated Agent Company Inc.	681257	Agent - Health	8/30/2016	2/5/2018
Inactive	Houchens Insurance Group, Inc.	637099	Agent - Life	8/31/2016	7/12/2017
Inactive	Houchens Insurance Group, Inc.	637099	Agent - Health	8/31/2016	7/12/2017