DEPARTMENT OF INSURANCE

Affiliations

Name	Citizens Bank	DOIID	399684	NAIC NPN	7221840

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	5/7/2026		3/31/2029
Active	Resident	Agent	Life	5/7/2026		3/31/2029
Denied	Resident	Agent	Limited Line Credit
Inactive	Resident	Agent	Credit Life & Health	3/16/1992	8/7/2000
Inactive	Resident	Agent	Mortgage Redemption	6/20/1995	8/7/2000
* 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	01/15/2027	03/31/2027	09/10/2026	09/10/2026	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American National Property and Casualty Company	300392	Agent - Limited Line Credit	2/28/2008	11/14/2011
Denied	Fidelity Security Life Insurance Company	300466	Agent - Health
Denied	Fidelity Security Life Insurance Company	300466	Agent - Life
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Limited Line Credit	8/7/2000	3/31/2021
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Mortgage Redemption	6/20/1995	8/7/2000
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Credit Life & Health	11/24/1998	8/7/2000
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Limited Line Credit	8/7/2000	3/31/2021
Inactive	NGL Insurance Company	300596	Agent - Credit Life & Health	7/26/1993	12/1/1998
Inactive	Protective Life Insurance Company	300638	Agent - Credit Life & Health	3/16/1992	3/31/1997

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bryant, Phyllis A	378370	Agent - Limited Line Credit	1/15/2004	3/11/2011
Inactive	Burnette, Michael Don	678483	Agent - Limited Line Credit	7/26/2010	8/21/2015
Inactive	Cagle, John Leslie	610296	Agent - Limited Line Credit	7/26/2010	8/21/2015
Inactive	Dame, John Bradley	613154	Agent - Limited Line Credit	7/26/2010	7/26/2013
Inactive	Evans, Bobby Gene	382526	Agent - Limited Line Credit	4/12/2004	1/14/2013
Inactive	Hobbs, Lea Ann	594353	Agent - Limited Line Credit	11/20/2020	3/31/2021
Inactive	Holland, David Ward	382915	Agent - Credit Life & Health	6/20/1995	8/7/2000
Inactive	Holland, David Ward	382915	Agent - Limited Line Credit	8/7/2000	1/26/2005
Inactive	Keene, Mary D	901441	Agent - Limited Line Credit	11/20/2020	3/31/2021
Active	Malone, Susan L	378844	Agent - Health	5/7/2026
Active	Malone, Susan L	378844	Agent - Life	5/7/2026
Inactive	Malone, Susan L	378844	Agent - Limited Line Credit	6/2/2023	1/31/2026
Pending	Murphy, Charles R	665634	Agent - Health
Pending	Murphy, Charles R	665634	Agent - Life
Inactive	Rice, Harold A	356363	Agent - Limited Line Credit	1/15/2004	5/23/2005
Inactive	Rice, William H	790814	Agent - Limited Line Credit	7/26/2013	12/31/2020
Inactive	Rodgers, Robert Chris	325551	Agent - Health	3/1/2011	3/25/2019
Inactive	Rodgers, Robert Chris	325551	Agent - Life	1/6/2005	3/25/2019
Inactive	Rodgers, Robert Chris	325551	Agent - Limited Line Credit	1/15/2004	3/25/2019
Inactive	Vowell, Anna A	374300	Agent - Limited Line Credit	1/15/2004	3/11/2011
Inactive	Ward, Wallace Andrew	518558	Agent - Limited Line Credit	1/15/2004	8/7/2006