DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Brachok, Kelsey Lauren	DOIID	946023	NAIC NPN	17567153

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	2/27/2017	9/30/2019
Inactive	Non Resident	Agent	Health	2/27/2017	9/30/2019
* 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	Freedom Life Insurance Company of America	300074	Agent - Health	3/14/2017	10/20/2018
Inactive	Freedom Life Insurance Company of America	300074	Agent - Life	3/14/2017	10/20/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Ushealth Advisors Llc	713288	Agent - Life	3/14/2017	10/20/2018
Inactive	Ushealth Advisors Llc	713288	Agent - Health	3/14/2017	10/20/2018