DEPARTMENT OF INSURANCE

Name	Kelley, Kolleen Kay	DOIID	350716	NAIC NPN	7191773

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Resident	Agent	Credit Life & Health	11/11/1996	8/7/2000
Inactive	Resident	Agent	Limited Line Credit	2/27/2004	6/30/2006

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

No License Renewal Information

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date. Licensees subject to CE must complete CE requirements before Next Compliance Date in order to successfully complete the License Renewal Process.

Address Information

Type	Address
Business / Home Office	Citizens State Bank 359 Court Street P.O. Box 37Wickliffe, KY 42087
Mailing	1723 Bethleham Church P.O. Box 786Wickliffe, KY 42087
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(270) 462-4501