DEPARTMENT OF INSURANCE

Affiliations

Name	Full Service Ins Inc	DOIID	573607	NAIC NPN	7811476

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	6/19/2009	3/31/2023
Inactive	Non Resident	Agent	Casualty	6/19/2009	3/31/2023
Inactive	Non Resident	Agent	Life	6/19/2009	3/31/2023
Inactive	Non Resident	Agent	Property	6/19/2009	3/31/2023
* 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	American Economy Insurance Company	300315	Agent - Casualty	11/9/2019	4/20/2020
Inactive	American Economy Insurance Company	300315	Agent - Property	11/9/2019	4/20/2020
Inactive	American Family Home Insurance Company	301817	Agent - Casualty	9/26/2021	3/31/2023
Inactive	American Family Home Insurance Company	301817	Agent - Property	9/26/2021	3/31/2023
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	7/15/2013	1/23/2015
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	7/15/2013	1/23/2015
Inactive	Ansur America Insurance Company	520667	Agent - Casualty	8/25/2016	3/31/2023
Inactive	Ansur America Insurance Company	520667	Agent - Property	8/25/2016	3/31/2023
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	2/10/2014	11/3/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Health	2/10/2014	11/3/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	2/10/2014	11/3/2016
Inactive	Cincinnati Insurance Company	301298	Agent - Casualty	12/2/2014	4/17/2020
Inactive	Cincinnati Insurance Company	301298	Agent - Property	12/2/2014	4/17/2020
Inactive	Cincinnati Life Insurance Company (The)	300601	Agent - Health	5/29/2015	4/17/2020
Inactive	Cincinnati Life Insurance Company (The)	300601	Agent - Life	5/29/2015	4/17/2020
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Health	7/2/2009	11/18/2020
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	7/2/2009	11/18/2020
Inactive	Crestbrook Insurance Company	805354	Agent - Casualty	7/12/2017	3/31/2023
Inactive	Crestbrook Insurance Company	805354	Agent - Property	7/12/2017	3/31/2023
Inactive	Encompass Indemnity Company	546376	Agent - Casualty	8/4/2015	4/8/2020
Inactive	Encompass Indemnity Company	546376	Agent - Property	8/4/2015	4/8/2020
Inactive	Encompass Insurance Company of America	556578	Agent - Casualty	8/4/2015	12/13/2018
Inactive	Encompass Insurance Company of America	556578	Agent - Property	8/4/2015	12/13/2018
Inactive	Frankenmuth Insurance Company	301481	Agent - Casualty	8/25/2016	3/31/2023
Inactive	Frankenmuth Insurance Company	301481	Agent - Property	8/25/2016	3/31/2023
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	11/11/2017	4/20/2018
Inactive	Humana Insurance Company	301104	Agent - Health	11/11/2017	4/20/2018
Inactive	Humana Insurance Company	301104	Agent - Life	11/11/2017	4/20/2018
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Casualty	7/12/2017	3/31/2023
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Property	7/12/2017	3/31/2023
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	8/14/2018	4/20/2020
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	8/14/2018	4/20/2020
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	8/14/2018	4/20/2020
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	8/14/2018	4/20/2020
Inactive	Travelers Property Casualty Company of America	301649	Agent - Casualty	1/13/2016	4/14/2020
Inactive	Travelers Property Casualty Company of America	301649	Agent - Property	1/13/2016	4/14/2020

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Forton, Justin Michael	696618	Agent - Health	6/19/2009	2/28/2015
Inactive	Forton, Justin Michael	696618	Agent - Life	6/19/2009	2/28/2015
Inactive	Pratt, Paul Meek	390288	Agent - Casualty	6/19/2009	3/31/2023
Inactive	Pratt, Paul Meek	390288	Agent - Health	5/27/2015	3/31/2023
Inactive	Pratt, Paul Meek	390288	Agent - Life	5/27/2015	3/31/2023
Inactive	Pratt, Paul Meek	390288	Agent - Property	6/19/2009	3/31/2023