DEPARTMENT OF INSURANCE

Affiliations

Name	Faulkner, Dennis A	DOIID	321820	NAIC NPN	2761147

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	9/5/1991	2/25/1999
Inactive	Resident	Agent	Life	9/5/1991	2/25/1999
* 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	Bankers Life and Casualty Company	300701	Agent - Health	7/24/1996	4/6/1998
Inactive	Bankers Life and Casualty Company	300701	Agent - Life	7/24/1996	4/6/1998
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	8/7/1996	2/25/1999
Inactive	Conseco Insurance Company	301202	Agent - Life	7/17/1996	2/25/1999
Inactive	Liberty Life Insurance Company	301542	Agent - Health	9/26/1991	6/24/1996
Inactive	Liberty Life Insurance Company	301542	Agent - Life	9/26/1991	6/24/1996
Inactive	LifeSecure Insurance Company	301629	Agent - Health	6/12/1996	2/25/1999
Inactive	LifeSecure Insurance Company	301629	Agent - Life	6/12/1996	2/25/1999
Inactive	LifeUSA Insurance Company	300386	Agent - Health	11/19/1991	2/25/1999
Inactive	LifeUSA Insurance Company	300386	Agent - Life	11/19/1991	2/25/1999
Inactive	Midland Life Insurance Company (The)	300310	Agent - Health	9/18/1996	2/25/1999
Inactive	Midland Life Insurance Company (The)	300310	Agent - Life	9/18/1996	2/25/1999
Inactive	National Foundation Life Insurance Company	300084	Agent - Health	6/18/1996	3/31/1997
Inactive	National Foundation Life Insurance Company	300084	Agent - Life	6/18/1996	3/31/1997
Inactive	National States Insurance Company	300579	Agent - Health	5/2/1997	1/14/1998
Inactive	National States Insurance Company	300579	Agent - Life	5/2/1997	1/14/1998
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	6/25/1996	2/25/1999
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	6/25/1996	2/25/1999
Inactive	Southwestern Life Insurance Company	301343	Agent - Health	3/20/1997	10/9/1998
Inactive	Southwestern Life Insurance Company	301343	Agent - Life	3/20/1997	10/9/1998
Inactive	Time Insurance Company	300683	Agent - Health	9/5/1991	11/11/1996
Inactive	Time Insurance Company	300683	Agent - Life	9/5/1991	11/11/1996
Inactive	Zurich American Life Insurance Company	300216	Agent - Life	8/7/1996	2/25/1999

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	World Marketing Alliance Inc.	398156	Agent - Life	5/6/1997	2/25/1999