DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Shannon, Josalyn Chantia	DOIID	970708	NAIC NPN	13864625

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	10/3/2017		9/30/2024
Active	Non Resident	Agent	Health	10/3/2017		9/30/2024
* 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	07/15/2024	09/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	3/28/2018	11/1/2018
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	11/3/2017	10/8/2021
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	11/3/2017	10/8/2021
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	11/3/2017	10/8/2021
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	11/3/2017	10/8/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Optavise, LLC	671337	Agent - Life	10/26/2020	10/8/2021
Inactive	Optavise, LLC	671337	Agent - Health	10/26/2020	10/8/2021