DEPARTMENT OF INSURANCE

Affiliations

Name	Khongsouvankham, Phoutthasong	DOIID	973089	NAIC NPN	16351752

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	5/4/2026		12/31/2027
Active	Non Resident	Agent	Property	5/4/2026		12/31/2027
Inactive	Non Resident	Agent	Health	7/8/2021	12/31/2021
Inactive	Non Resident	Agent	Life	7/8/2021	12/31/2021
* 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	AIG Property Casualty Company	300621	Agent - Casualty	3/8/2020	12/31/2021
Inactive	AIG Property Casualty Company	300621	Agent - Property	3/8/2020	12/31/2021
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	7/14/2021	12/31/2021
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/14/2021	12/31/2021
Inactive	Aetna Life Insurance Company	301140	Agent - Health	7/14/2021	12/31/2021
Active	American Modern Home Insurance Company	300791	Agent - Casualty	5/20/2026
Active	American Modern Home Insurance Company	300791	Agent - Property	5/20/2026
Inactive	American Strategic Insurance Corp	883540	Agent - Casualty	6/10/2020	12/31/2021
Inactive	American Strategic Insurance Corp	883540	Agent - Property	6/10/2020	12/31/2021
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	11/15/2018	11/25/2019
Inactive	Bristol West Insurance Company	301655	Agent - Property	11/15/2018	11/25/2019
Inactive	Homesite Insurance Company	301139	Agent - Casualty	10/31/2019	11/22/2019
Inactive	Homesite Insurance Company	301139	Agent - Property	10/31/2019	11/22/2019
Inactive	Homesite Insurance Company of the Midwest	874850	Agent - Casualty	10/31/2019	11/22/2019
Inactive	Homesite Insurance Company of the Midwest	874850	Agent - Property	10/31/2019	11/22/2019
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	7/29/2021	2/22/2022
Inactive	LM General Insurance Company	300133	Agent - Casualty	4/6/2018	11/22/2019
Inactive	LM General Insurance Company	300133	Agent - Property	4/6/2018	11/22/2019
Inactive	LM Insurance Corporation	301061	Agent - Casualty	2/13/2018	11/22/2019
Inactive	LM Insurance Corporation	301061	Agent - Property	2/13/2018	11/22/2019
Inactive	Liberty Insurance Corporation	300444	Agent - Casualty	10/31/2017	11/22/2019
Inactive	Liberty Insurance Corporation	300444	Agent - Property	10/31/2017	11/22/2019
Inactive	Liberty Mutual Personal Insurance Company	959584	Agent - Casualty	9/22/2018	11/22/2019
Inactive	Liberty Mutual Personal Insurance Company	959584	Agent - Property	9/22/2018	11/22/2019
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	2/18/2019	12/31/2021
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	2/18/2019	12/31/2021
Inactive	SilverScript Insurance Company	663526	Agent - Health	7/14/2021	12/31/2021
Inactive	Travelers Personal Insurance Company	705785	Agent - Casualty	6/27/2019	12/11/2019
Inactive	Travelers Personal Insurance Company	705785	Agent - Property	6/27/2019	12/11/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Texas Wasatch Insurance Services LP	990805	Agent - Property	6/11/2026
Active	Texas Wasatch Insurance Services LP	990805	Agent - Casualty	6/11/2026