DEPARTMENT OF INSURANCE

Name	Cooper Insurance Inc. DBA : Kentucky Mountain Insurance	DOIID	399778	NAIC NPN	7221924

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	General Lines	1/5/1983	8/15/2000
Inactive	Resident	Agent	Casualty	8/15/2000	3/31/2013
Inactive	Resident	Agent	Assessment Chapter 299	10/16/1997	12/1/2000
Inactive	Resident	Agent	Property	8/15/2000	3/31/2013
Inactive	Resident	Agent	Life	5/31/2001	3/31/2013
Inactive	Resident	Agent	Credit Life & Health	4/26/1993	12/21/1998
Inactive	Resident	Agent	Health Maintenance Organization	11/7/1991	3/1/2001
Inactive	Resident	Agent	Health	2/22/1993	3/31/2013

*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.

Address Information

Type	Address
Business / Home Office	100 Cooksey Street P. O. Box 540Hazard, KY 41702

Phone Information

Type	Phone
Business / Home Office	(606) 436-5702