DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Lally, Amber	DOIID	934710	NAIC NPN	18127349

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Pending Replacement	Non Resident	Agent	Life	10/26/2016		6/30/2024
Pending Replacement	Non Resident	Agent	Health	10/26/2016		6/30/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	04/15/2024	06/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Fidelity Investments Life Insurance Company	300620	Agent - Health	10/27/2016	5/12/2020
Pending Replacement	Fidelity Investments Life Insurance Company	300620	Agent - Life	3/7/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Fidelity Health Insurance Services LLC	887889	Agent - Health
Denied	Fidelity Health Insurance Services LLC	887889	Agent - Life