DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Acrisure Wallstreet Partners, LLC	DOIID	1020531	NAIC NPN	18293503

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	11/29/2018		3/31/2026
Active	Non Resident	Agent	Health	11/29/2018		3/31/2026
* 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	01/15/2026	03/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Accendo Insurance Company	300312	Agent - Life	12/18/2020
Active	Aetna Health Inc. (PA)	660717	Agent - Health	2/24/2020
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	12/18/2020
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/6/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	2/24/2020
Active	Aetna Life Insurance Company	301140	Agent - Life	2/24/2020
Inactive	American Continental Insurance Company	643130	Agent - Life	12/18/2020	8/11/2021
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	1/24/2019
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	1/24/2019
Active	Continental American Insurance Company	301700	Agent - Health	3/18/2019
Active	Continental American Insurance Company	301700	Agent - Life	3/18/2019
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	12/18/2020
Active	Great Midwest Insurance Company	301418	Agent - Health	6/17/2019
Active	Imperium Insurance Company	300804	Agent - Health	6/17/2019
Active	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	4/2/2019
Active	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	4/2/2019
Active	SilverScript Insurance Company	663526	Agent - Health	11/1/2019
Active	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	4/7/2022
Active	WellCare Prescription Insurance Inc.	654329	Agent - Health	4/7/2022

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Ackles, Judy Ann	748728	Agent - Life
Inactive	Brenneke, Shannon Marie	1363615	Agent - Health	10/1/2024	5/29/2025
Denied	Brenneke, Shannon Marie	1363615	Agent - Life
Inactive	Cliburn, David	1088239	Agent - Health	7/21/2020	6/14/2024
Inactive	Cliburn, David	1088239	Agent - Life	7/21/2020	6/14/2024
Active	Kolenda, Courtney Lynne	1022910	Agent - Health	6/10/2019
Active	Kolenda, Courtney Lynne	1022910	Agent - Life	7/1/2019
Inactive	Parker, William L	511526	Agent - Health	11/29/2018	1/22/2020
Inactive	Parker, William L	511526	Agent - Life	11/29/2018	1/22/2020
Inactive	Sepesi, Jeffrey P	321030	Agent - Health	12/17/2021	6/4/2025
Inactive	Sepesi, Jeffrey P	321030	Agent - Life	12/17/2021	6/4/2025
Inactive	Wilbers, Leroy	1021275	Agent - Health	7/30/2019	6/2/2020
Inactive	Wilbers, Leroy	1021275	Agent - Life	7/30/2019	6/2/2020