DEPARTMENT OF INSURANCE
Course Attendance Information
PR01597: Kentucky Self Insurers Association
Experior Provider Number: S16710 
Provider Type: Independent
Certification Date: 7/26/2011

Address: 5932 Timber Ridge Dr.
Ste. 101
Prospect, KY 40059
Contact: Angela Underwood
Telephone: 502-223-5322
Status: Active
Termination Date: N/A
View Instructors

Course Attendees
Course Name :  FunctionalCapacityEvaluationForWorkersComp-Provi-C
DOI IDNameCompletion Date Compliance Date
343652 Martin, Bernita Sue 05/21/2024 11/30/2025
322397 Thompson, Linda Carol 05/21/2024 08/31/2025
311798 Truax, Cathy Marie 05/21/2024 03/31/2025
535834 Geary, Laura Elizabeth 05/21/2024 09/30/2024
571363 Armbruster, Stephanie Leigh 05/21/2024 01/31/2026
367394 Brown, Kristi Jane 05/21/2024 12/31/2024
333847 Crawford, Tracy Lynn 05/21/2024 01/31/2026
338657 Elliott, Lisa M 05/21/2024 09/30/2024
312407 English, Patrick Gerard 05/21/2024 10/31/2025
336479 Gabbard, Angela Marie 05/21/2024 11/30/2025
1272265 Hawkins, Bettina Lynn 05/21/2024 02/28/2026
375112 Lovelace, Cynthia Anna 05/21/2024 08/31/2024
514532 Mackie, Connie Mackie 05/21/2024 12/31/2026
347534 McIntosh, Robin C 05/21/2024 01/31/2026
864490 Senters, Kristine L 05/21/2024 02/28/2026
351204 Snook, Ruth Lynn 05/21/2024 02/28/2026
344074 Kleier, Cindy 05/21/2024 04/30/2025
333152 Ladegast, Linda Carol 05/21/2024 01/31/2026
313195 Long, Judy Bartlett 05/21/2024 11/30/2024
322004 Meredith, Edward W 05/21/2024 03/31/2026
535240 Milam, Penny Michelle 05/21/2024 08/31/2025
345309 Payton, Desiree Lynn 05/21/2024 10/31/2024
752799 Petrie, Heather Lyn 05/21/2024 02/28/2026
549323 Askins, Julia A 05/21/2024 03/31/2026
671252 Brown, Michael Joseph 05/21/2024 11/30/2024
1273369 Sears, Regina 05/21/2024 07/31/2024
327733 Wheatley, Charles Brian 05/21/2024 02/28/2026
883746 Wilson, Robert Wayne 05/21/2024 12/31/2025
586067 Hopper, Angela Marie 05/21/2024 07/31/2025
316780 Jones, Dorothea 05/21/2024 05/31/2025
390625 Patrick, Doyle F 05/21/2024 07/31/2025
339619 Stayton, Traci L 05/21/2024 10/31/2024
1063774 Taylor, Stephanie Elaine 05/21/2024 10/31/2024

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