DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Mitchell, Kimberly Faye	DOIID	341348	NAIC NPN	5966491

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	9/17/1998	7/1/2002
Inactive	Resident	Agent	Health	9/17/1998	7/1/2002
Inactive	Resident	Agent	Health Maintenance Organization	7/24/2000	3/1/2001
* 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	Anthem Life Insurance Company	301209	Agent - Health	9/17/1998	7/1/2002
Inactive	Anthem Life Insurance Company	301209	Agent - Life	9/17/1998	7/1/2002

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Commonwealth Health Corporation	400683	Agent - Life	10/13/1998	7/1/2002
Inactive	Commonwealth Health Corporation	400683	Agent - Health	10/13/1998	7/1/2002
Inactive	Commonwealth Health Corporation	400683	Agent - Health Maintenance Organization	7/24/2000	3/1/2001