DEPARTMENT OF INSURANCE

Affiliations

Name	Brock, Dallas Lee	DOIID	318927	NAIC NPN	7167305

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	5/15/2015	11/1/2017
Inactive	Resident	Agent	Life	5/14/2015	11/1/2017
* 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 General Life and Accident Insurance Company	301362	Agent - Health	1/29/2003	12/2/2003
Inactive	American General Life and Accident Insurance Company	301362	Agent - Life	1/29/2003	12/2/2003
Inactive	Anthem Life Insurance Company	301209	Agent - Health	6/3/1998	3/10/1999
Inactive	Anthem Life Insurance Company	301209	Agent - Life	6/3/1998	3/10/1999
Inactive	Continental General Insurance Company	300691	Agent - Health	12/22/1998	7/19/1999
Inactive	Continental General Insurance Company	300691	Agent - Life	12/22/1998	7/19/1999
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Health	7/30/1998	7/1/2006
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	7/30/1998	7/1/2006
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Health	12/15/1992	7/1/2006
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Life	12/15/1992	7/1/2006
Inactive	Liberty Life Insurance Company	301542	Agent - Health	3/3/1999	9/27/1999
Inactive	Liberty Life Insurance Company	301542	Agent - Life	3/3/1999	9/27/1999
Inactive	Peoples Benefit Life Insurance Company	301895	Agent - Life	7/8/1997	7/1/2006
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	9/8/1999	10/24/2003
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	9/8/1999	10/24/2003
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	5/18/2015	11/1/2017
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	5/18/2015	11/1/2017
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	5/18/2015	8/22/2016
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	5/18/2015	8/22/2016
Inactive	Unity Mutual Life Insurance Company	300100	Agent - Health	9/27/1999	7/1/2006
Inactive	Unity Mutual Life Insurance Company	300100	Agent - Life	9/27/1999	7/1/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	5/14/1998	3/8/1999
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	5/14/1998	3/8/1999