DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Riverside Demand Services, LLC	DOIID	958710	NAIC NPN	18383316

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	5/29/2019		3/31/2027
Active	Non Resident	Agent	Health	5/29/2019		3/31/2027
* 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
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	6/10/2019
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	6/10/2019
Inactive	American National Insurance Company	301861	Agent - Health	8/3/2017	2/14/2019
Inactive	American National Insurance Company	301861	Agent - Life	8/3/2017	2/14/2019
Inactive	Gerber Life Insurance Company	300529	Agent - Health	7/16/2019	2/5/2025
Inactive	Gerber Life Insurance Company	300529	Agent - Life	7/16/2019	2/5/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Reboin, James Michael	836052	Agent - Health	6/27/2017	1/31/2019
Inactive	Reboin, James Michael	836052	Agent - Life	6/27/2017	1/31/2019
Active	Skoda, Bradley	1023457	Agent - Health	5/29/2019
Active	Skoda, Bradley	1023457	Agent - Life	5/29/2019