DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Bosworth, Charles M	DOIID	311224	NAIC NPN	1314461

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	9/28/1992	12/31/2005
Inactive	Non Resident	Agent	Life	9/28/1992	12/31/2005
* 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	Genworth Life and Annuity Insurance Company	301276	Agent - Health	4/16/2003	12/31/2005
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	4/16/2003	12/31/2005
Inactive	Pruco Life Insurance Company	300954	Agent - Health	9/28/1992	12/31/2005
Inactive	Pruco Life Insurance Company	300954	Agent - Life	9/28/1992	12/31/2005
Inactive	Prudential Insurance Company of America	300784	Agent - Health	10/20/1992	12/31/2005
Inactive	Prudential Insurance Company of America	300784	Agent - Life	10/20/1992	12/31/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Prudential Equity Group, LLC	399017	Agent - Life	2/16/2004	3/4/2005
Inactive	Prudential Equity Group, LLC	399017	Agent - Health	2/16/2004	3/4/2005
Inactive	Wells Fargo Advisors Insurance Agency LLC	399972	Agent - Life	5/3/2005	12/31/2005
Inactive	Wells Fargo Advisors Insurance Agency LLC	399972	Agent - Health	5/3/2005	12/31/2005