DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Mitchell, Douglas Cameron	DOIID	898145	NAIC NPN	712737

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/13/2020	9/30/2023
Inactive	Non Resident	Agent	Life	10/13/2020	9/30/2023
* 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	Golden Rule Insurance Company	301943	Agent - Health	6/15/2016	6/21/2017
Inactive	Golden Rule Insurance Company	301943	Agent - Life	6/15/2016	6/21/2017
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	9/15/2021	9/30/2023
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	9/15/2021	9/30/2023
Inactive	Starmount Life Insurance Company	628031	Agent - Health	9/15/2021	9/30/2023
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	9/15/2021	9/30/2023
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	9/15/2021	9/30/2023
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	5/26/2016	3/2/2017
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/11/2016	3/2/2017
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	6/15/2016	10/7/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	6/15/2016	10/7/2016
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	5/26/2016	12/5/2016
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	5/26/2016	3/2/2017
Inactive	Unum Insurance Company	301499	Agent - Health	9/15/2021	9/30/2023
Inactive	Unum Insurance Company	301499	Agent - Life	9/15/2021	9/30/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Willis Of Illinois Inc	398318	Agent - Life	11/21/2016	9/30/2019
Inactive	Willis Of Illinois Inc	398318	Agent - Health	11/21/2016	9/30/2019
Inactive	Willis Towers Watson Midwest, Inc	534348	Agent - Life	10/14/2022	12/16/2022
Inactive	Willis Towers Watson Midwest, Inc	534348	Agent - Health	10/14/2022	12/16/2022