PUBLIC PROTECTION
CABINET
DEPARTMENT OF INSURANCE
Affiliations
NameNational Association of Insurance MarketersDOIID562465NAIC NPN4567340
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentLife1/21/2003 3/31/2027
ActiveNon ResidentAgentHealth1/21/2003 3/31/2027
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent01/15/202503/31/202501/20/202501/20/2025Yes
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAmerican General Life Insurance Company301585Agent - Health5/2/20139/8/2015
InactiveAmerican General Life Insurance Company301585Agent - Life5/2/20139/8/2015
InactiveAmerican Pioneer Life Insurance Company301782Agent - Health7/10/20042/10/2015
InactiveAmerican Pioneer Life Insurance Company301782Agent - Life7/10/20042/10/2015
ActiveAssurity Life Insurance Company301099Agent - Health1/27/2009 
ActiveAssurity Life Insurance Company301099Agent - Life1/27/2009 
InactiveAthene Annuity and Life Company301893Agent - Life9/19/20087/10/2014
ActiveBanner Life Insurance Company301696Agent - Life2/2/2010 
InactiveGuarantee Trust Life Insurance Company301043Agent - Health3/11/20081/31/2011
InactiveGuarantee Trust Life Insurance Company301043Agent - Life3/11/20081/31/2011
InactiveIndianapolis Life Insurance Company301381Agent - Life7/28/200510/1/2008
InactiveLincoln National Life Insurance Company (The)301382Agent - Health5/16/20118/31/2020
InactiveLincoln National Life Insurance Company (The)301382Agent - Life5/16/20118/31/2020
ActiveMadison National Life Insurance Company Inc.301458Agent - Health8/14/2009 
ActiveMadison National Life Insurance Company Inc.301458Agent - Life8/14/2009 
InactiveMutual Trust Life Insurance Company, A Pan-American Life Insurance Group Stock Company300585Agent - Life3/3/201612/31/2022
InactiveNassau Life Insurance Company of Texas300872Agent - Health7/10/200412/30/2005
InactiveNassau Life Insurance Company of Texas300872Agent - Life7/10/20041/7/2014
InactiveNational Guardian Life Insurance Company300596Agent - Health8/25/20032/26/2007
InactiveNational Guardian Life Insurance Company300596Agent - Life8/25/20032/26/2007
ActiveNational Health Insurance Company300554Agent - Health11/14/2023 
ActiveNational Health Insurance Company300554Agent - Life11/14/2023 
InactiveNational Western Life Insurance Company301515Agent - Life2/5/20146/20/2019
InactivePan-American Assurance Company301533Agent - Health12/30/20035/5/2005
InactivePan-American Assurance Company301533Agent - Life12/30/20035/5/2005
InactivePan-American Life Insurance Company301530Agent - Health12/30/20035/5/2005
ActivePan-American Life Insurance Company301530Agent - Life12/31/2022 
InactiveReserve National Insurance Company301073Agent - Health10/2/20139/3/2019
InactiveReserve National Insurance Company301073Agent - Life10/2/20139/3/2019
InactiveSecurian Life Insurance Company300757Agent - Health1/17/20075/21/2018
InactiveSecurian Life Insurance Company300757Agent - Life1/17/20075/21/2018
InactiveSentry Life Insurance Company301461Agent - Health3/27/201510/13/2016
InactiveSentry Life Insurance Company301461Agent - Life3/27/201510/13/2016
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveHildebrand, Edwin A 324810Agent - Health2/14/2005 
ActiveHildebrand, Edwin A 324810Agent - Life2/14/2005 
InactiveJohnson, Phillip K 645564Agent - Health1/26/20079/13/2016
InactiveJohnson, Phillip K 645564Agent - Life1/26/20079/13/2016
ActiveRusso, James Henry 393659Agent - Health2/14/2005 
ActiveRusso, James Henry 393659Agent - Life2/14/2005 
ActiveStolz, Richard Walter 515005Agent - Health10/12/2016 
ActiveStolz, Richard Walter 515005Agent - Life9/13/2016 

© Commonwealth of Kentucky. All rights reserved.