DEPARTMENT OF INSURANCE

Affiliations

Name	Urivetzky, Lewis M	DOIID	724512	NAIC NPN	9663748

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	5/23/2013	10/31/2018
Inactive	Non Resident	Agent	Life	5/23/2013	10/31/2018
* 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	AXA XL Insurance Company Americas	300979	Agent - Health	4/24/2014	10/31/2018
Inactive	AXIS Insurance Company	301290	Agent - Health	9/23/2016	10/31/2018
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	9/29/2014	7/6/2015
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	9/29/2014	7/6/2015
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	4/25/2014	8/14/2015
Inactive	Companion Life Insurance Company	300191	Agent - Health	4/21/2010	10/31/2012
Inactive	Companion Life Insurance Company	300191	Agent - Life	4/4/2011	10/31/2012
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	4/25/2014	8/14/2015
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Health	8/31/2016	12/6/2018
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Life	8/31/2016	12/6/2018
Inactive	HCC Life Insurance Company	301827	Agent - Health	7/14/2016	10/3/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	4/25/2014	8/14/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	4/25/2014	8/14/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	4/25/2014	8/14/2015
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/25/2014	8/14/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/25/2014	8/14/2015
Inactive	Medico Corp Life Insurance Company	301777	Agent - Health	9/2/2014	4/26/2015
Inactive	Medico Corp Life Insurance Company	301777	Agent - Life	9/2/2014	4/26/2015
Inactive	Medico Insurance Company	301559	Agent - Health	9/4/2014	4/26/2015
Inactive	Medico Insurance Company	301559	Agent - Life	9/4/2014	4/26/2015
Inactive	Reserve National Insurance Company	301073	Agent - Health	7/30/2014	10/27/2015
Inactive	Reserve National Insurance Company	301073	Agent - Life	7/30/2014	10/27/2015
Inactive	SILAC Insurance Company	300535	Agent - Health	8/4/2014	2/5/2015
Inactive	SILAC Insurance Company	300535	Agent - Life	8/4/2014	2/5/2015
Inactive	Starr Indemnity and Liability Company	301685	Agent - Health	10/14/2011	10/31/2012
Inactive	Unified Life Insurance Company	543169	Agent - Health	1/25/2018	12/6/2018
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	7/22/2014	10/31/2018
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	7/22/2014	10/31/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Infinity Direct Ins Llc	806942	Agent - Life	4/25/2014	3/31/2015
Inactive	Infinity Direct Ins Llc	806942	Agent - Health	4/24/2014	3/31/2015