DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Mullins, Thomas W	DOIID	309265	NAIC NPN	7159772

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	4/20/1998	12/1/2000
Inactive	Resident	Agent	Life	4/20/1998	12/1/2000
Inactive	Resident	Agent	Health Maintenance Organization	12/17/1998	12/1/2000
* 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	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	6/9/1998	12/1/2000
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	6/9/1998	12/1/2000
Inactive	First Colony Life Insurance Company	301179	Agent - Life	3/2/1999	12/1/2000
Inactive	Grange Life Insurance Company	300128	Agent - Health	4/20/1998	12/1/2000
Inactive	Grange Life Insurance Company	300128	Agent - Life	4/20/1998	12/1/2000
Inactive	Lincoln Benefit Life Company	301110	Agent - Health	6/22/1998	12/1/2000
Inactive	Lincoln Benefit Life Company	301110	Agent - Life	6/22/1998	12/1/2000
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	6/17/1998	12/1/2000
Inactive	Penn Treaty Network America Insurance Company	301297	Agent - Health	6/17/1998	12/15/1998
Inactive	Penn Treaty Network America Insurance Company	301297	Agent - Life	6/17/1998	12/15/1998
Inactive	Pioneer Life Insurance Company	300110	Agent - Health	7/9/1998	12/1/2000
Inactive	Pioneer Life Insurance Company	300110	Agent - Life	7/9/1998	12/1/2000
Inactive	Principal Life Insurance Company	300129	Agent - Health	9/25/1998	12/1/2000
Inactive	Principal Life Insurance Company	300129	Agent - Life	9/25/1998	12/1/2000
Inactive	Time Insurance Company	300683	Agent - Health	4/28/1999	12/1/2000
Inactive	Time Insurance Company	300683	Agent - Life	4/28/1999	12/1/2000
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Health	5/6/1999	12/1/2000
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Life	5/6/1999	12/1/2000
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health Maintenance Organization	12/17/1998	12/1/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Western Kentucky Insurance Agency Inc.	399738	Agent - Life	5/1/1998	12/1/2000
Inactive	Western Kentucky Insurance Agency Inc.	399738	Agent - Health	5/1/1998	12/1/2000