DEPARTMENT OF INSURANCE

Affiliations

Name	Johnson, Kyle Dean	DOIID	946025	NAIC NPN	7659432

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Administrator	Not Applicable	2/27/2017		12/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Fairview Pharmacy Services LLC	931171	Administrator - Not Applicable	3/7/2017