black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

PAMELA RETRICE CORNELIOUS

PRODUCER NON-RESIDENT

License Number:
PRN244144
Status:
First Licensure:
12/31/2014
Cancel Date:
None

Mailing:
LOCUST GROVE, GA 30248
Phone:
+1 (678) 972-5410
Fax:
+1 (770) 961-0703
Email:
pcornelious1@hotmail.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 12/31/2014

Agency

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

Employer

Name Issue Date License Number Expiration Date Cancel Date
ARCADIAN HEALTH PLAN INC
05/12/2015 HMF112421 12/08/2015
BANKERS FIDELITY LIFE INSURANCE COMPANY
10/04/2018 LHF84789 05/28/2021
CONTINENTAL AMERICAN INSURANCE COMPANY
05/20/2019 LHF80843 09/21/2023
HUMANA BENEFIT PLAN OF ILLINOIS INC
05/12/2015 LHF202755 12/08/2015
HUMANA INSURANCE COMPANY
01/16/2015 LHF980 03/31/2015
HUMANA INSURANCE COMPANY
05/12/2015 LHF980 12/08/2015
HUMANADENTAL INSURANCE COMPANY
01/16/2015 LHF173873 03/31/2015
HUMANADENTAL INSURANCE COMPANY
05/12/2015 LHF173873 12/08/2015
PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY
10/19/2018 LHF250 07/29/2021
PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY
04/29/2025 LHF250
STARMOUNT LIFE INSURANCE COMPANY
10/19/2018 LHD131525 07/29/2021
STARMOUNT LIFE INSURANCE COMPANY
04/29/2025 LHD131525
UNUM INSURANCE COMPANY
10/19/2018 LHD241 07/29/2021
UNUM INSURANCE COMPANY
04/29/2025 LHD241
UNUM LIFE INSURANCE COMPANY OF AMERICA
10/19/2018 LHD145 07/29/2021
UNUM LIFE INSURANCE COMPANY OF AMERICA
04/29/2025 LHD145

Authority

Description Issue Date Termination Date Status
HEALTH 12/31/2014 Active
LIFE 12/31/2014 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
9194853

Other Addresses

Address Type
LOCUST GROVE, GA 30248
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: 06/08/2025 01:01:09 PM