black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

LAURETTA MBANG ANNAH

PRODUCER NON-RESIDENT

License Number:
PRN318041
Status:
First Licensure:
09/27/2018
Cancel Date:
None

Mailing:
MCDONOUGH, GA 30253
Phone:
+1 (510) 364-2114
Fax:
+1 (678) 723-0266
Email:
lavani0717@yahoo.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 09/27/2018

Agency

Name Issue Date License Number Expiration Date Cancel Date
OPTAVISE LLC
10/22/2018 AGN167845 04/21/2020

Employer

Name Issue Date License Number Expiration Date Cancel Date
PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY
08/13/2019 LHF250
RELIASTAR LIFE INSURANCE COMPANY
08/23/2019 LHF22 02/25/2021
STARMOUNT LIFE INSURANCE COMPANY
08/13/2019 LHD131525
TRUSTMARK INSURANCE COMPANY
10/04/2018 LHF132 05/04/2022
UNUM INSURANCE COMPANY
08/13/2019 LHD241
UNUM LIFE INSURANCE COMPANY OF AMERICA
08/13/2019 LHD145

Authority

Description Issue Date Termination Date Status
HEALTH 09/27/2018 Active
LIFE 09/27/2018 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
3116825

Other Addresses

Address Type
MCDONOUGH, GA 30253
Office

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 01/08/2026 05:13:16 AM