DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Birch, Mary	DOIID	338569	NAIC NPN	7007100

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Adjuster	Independent	2/28/1997	9/30/2007
Inactive	Resident	Agent	Life	6/18/2004	9/30/2007
Inactive	Resident	Agent	Health	6/18/2004	9/30/2007
Inactive	Resident	Apprentice Adjuster	Not Applicable	2/7/1996	2/7/1997
* 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	Investors Life Insurance Company of North America	301660	Agent - Life	2/14/2006	9/30/2007
Inactive	Midland National Life Insurance Company	300923	Agent - Health	6/30/2004	9/30/2007
Inactive	Midland National Life Insurance Company	300923	Agent - Life	6/30/2004	9/30/2007

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	GuideOne Insurance Company	301794	Adjuster - Independent	2/28/1997	9/30/2007
Inactive	Williams Insurance Service Inc.	399305	Agent - Health	1/24/2005	9/30/2007
Inactive	Williams Insurance Service Inc.	399305	Agent - Life	1/24/2005	9/30/2007

Sponsored By

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Henn, William E	393425	Apprentice Adjuster - Not Applicable	2/7/1996	2/7/1997