DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Grignon, Donald R	DOIID	307216	NAIC NPN	7158864

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	8/11/1994	7/1/1996
Inactive	Resident	Agent	Life	5/31/2001	7/1/2004
* 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	Alexander Hamilton Life Insurance Co. of America	301779	Agent - Health	10/26/1994	7/1/1996
Inactive	Alexander Hamilton Life Insurance Co. of America	301779	Agent - Life	10/26/1994	7/1/1996
Inactive	Central States Health and Life Company of Omaha	301874	Agent - Life	5/20/2002	7/1/2004
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	7/24/2003	7/1/2004
Inactive	North American Company for Life and Health Insurance	300291	Agent - Health	10/31/1995	7/1/1996
Inactive	North American Company for Life and Health Insurance	300291	Agent - Life	10/31/1995	7/1/1996
Inactive	Northwestern Mutual Life Insurance Company	300931	Agent - Health	8/11/1994	1/24/1996
Inactive	Northwestern Mutual Life Insurance Company	300931	Agent - Life	8/11/1994	1/24/1996
Inactive	Standard Insurance Company	300185	Agent - Health	2/8/1995	7/1/1996
Inactive	Standard Insurance Company	300185	Agent - Life	2/8/1995	7/1/1996
Inactive	Time Insurance Company	300683	Agent - Health	12/19/1995	7/1/1996
Inactive	Time Insurance Company	300683	Agent - Life	12/19/1995	7/1/1996
Inactive	Western National Life Insurance Company	300461	Agent - Life	5/31/2001	7/1/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Natcity Insurance Services Inc.	400871	Agent - Life	2/21/2003	7/1/2004