DEPARTMENT OF INSURANCE

Affiliations

Name	Dorsey, Seriozha Simone	DOIID	905961	NAIC NPN	17777112

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	5/22/2025	2/28/2027
Active	Non Resident	Agent	Health	5/22/2025	2/28/2027
* 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	12/15/2026	02/28/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Accendo Insurance Company	300312	Agent - Health	4/11/2022	2/28/2023
Inactive	Accendo Insurance Company	300312	Agent - Life	4/11/2022	2/28/2023
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	4/11/2022	2/28/2023
Inactive	American General Life Insurance Company	301585	Agent - Health	10/31/2016	3/30/2022
Inactive	American General Life Insurance Company	301585	Agent - Life	10/31/2016	3/30/2022
Inactive	CMFG Life Insurance Company	300929	Agent - Life	10/9/2025	5/28/2026
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	4/11/2022	2/28/2023
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	4/11/2022	2/28/2023
Inactive	Gerber Life Insurance Company	300529	Agent - Health	10/14/2020	3/14/2022
Inactive	Gerber Life Insurance Company	300529	Agent - Life	4/22/2020	3/14/2022
Inactive	Globe Life and Accident Insurance Company	300639	Agent - Health	12/16/2016	12/15/2021
Inactive	Globe Life and Accident Insurance Company	300639	Agent - Life	12/16/2016	12/15/2021
Inactive	Lumico Life Insurance Company	300354	Agent - Life	10/1/2019	4/13/2022
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	8/12/2019	1/14/2022
Inactive	Omaha Insurance Company	751908	Agent - Health	10/28/2016	8/8/2018
Inactive	Pruco Life Insurance Company	300954	Agent - Life	11/7/2016	1/12/2022
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	1/24/2017	1/26/2022
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	1/24/2017	1/26/2022
Inactive	United World Life Insurance Company	300532	Agent - Health	5/13/2020	1/14/2022
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	10/27/2016	1/14/2022
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	10/27/2016	1/14/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Ethos Technologies Inc.	934675	Agent - Life	2/10/2026	5/28/2026
Denied	Ethos Technologies Inc.	934675	Agent - Health