DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

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	Health	10/3/2017		9/30/2026
Active	Non Resident	Agent	Life	10/3/2017		9/30/2026
* 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	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