DEPARTMENT OF INSURANCE

Affiliations

Name	Mitchell, Angela Deneen	DOIID	342123	NAIC NPN	7187974

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Administrator	Not Applicable	3/31/1999	9/30/2006
Inactive	Resident	Agent	Health Maintenance Organization	11/26/1997	3/1/2001
Inactive	Resident	Agent	General Lines	4/20/1993	8/12/1996
Inactive	Resident	Agent	Life	5/18/1998	7/1/2006
Inactive	Resident	Agent	Prepaid Dental Plan	9/29/1998	4/2/2001
Inactive	Resident	Agent	Health	5/18/1998	7/1/2006
* 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 United Life Assurance Company	300296	Agent - Health	1/31/2000	12/31/2001
Inactive	Bankers United Life Assurance Company	300296	Agent - Life	1/31/2000	12/31/2001
Inactive	Countryway Insurance Company	300809	Agent - General Lines	12/28/1995	8/5/1996
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - General Lines	6/5/1996	8/12/1996
Inactive	Fort Wayne Health & Casualty Insurance Company	301572	Agent - Health	9/29/1998	12/22/2004
Inactive	Health Resources Inc.	301210	Agent - Prepaid Dental Plan	9/29/1998	4/2/2001
Inactive	Life Investors Insurance Company of America	301793	Agent - Health	12/31/2001	8/23/2003
Inactive	Life Investors Insurance Company of America	301793	Agent - Life	12/31/2001	8/23/2003
Inactive	Lincoln National Reassurance Company	301919	Agent - Health	6/3/1998	1/6/2003
Inactive	Lincoln National Reassurance Company	301919	Agent - Life	6/3/1998	1/6/2003
Inactive	Metropolitan General Insurance Company	300709	Agent - General Lines	6/5/1996	8/12/1996
Inactive	Owensboro Community Health Plan HMO Inc.	300906	Agent - Health Maintenance Organization	11/26/1997	8/26/1999
Inactive	Principal Life Insurance Company	300129	Agent - Health	3/27/2000	7/1/2006
Inactive	Principal Life Insurance Company	300129	Agent - Life	3/27/2000	7/1/2006
Inactive	State Farm General Insurance Company	301122	Agent - General Lines	4/20/1993	3/31/1996
Inactive	State Farm Mutual Automobile Insurance Company	301732	Agent - General Lines	4/20/1993	3/31/1996
Inactive	Swiss Re Life & Health America, Inc.	300722	Agent - Health	1/6/2003	12/22/2004
Inactive	Swiss Re Life & Health America, Inc.	300722	Agent - Life	1/6/2003	12/22/2004
Inactive	Transamerica Assurance Company	300893	Agent - Health	9/24/2001	10/1/2004
Inactive	Transamerica Assurance Company	300893	Agent - Life	9/24/2001	10/1/2004
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	7/6/2004	7/1/2006
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	7/6/2004	7/1/2006
Inactive	United American Insurance Company	300910	Agent - Health	5/18/1998	7/1/2006
Inactive	United American Insurance Company	300910	Agent - Life	5/18/1998	7/1/2006
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	11/23/1999	11/22/2005
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	11/23/1999	11/22/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Autoinsurance Network, Inc.	398917	Agent - General Lines	1/26/1996	7/1/1996
Inactive	Custom Health Plans Inc.	401295	Administrator - Not Applicable	3/31/1999	9/30/2006
Inactive	Custom Health Plans Inc.	401295	Agent - Health Maintenance Organization	3/25/1999	11/18/1999
Inactive	G.D.S. Group LLC	400241	Agent - Life	3/4/2003	7/1/2006
Inactive	G.D.S. Group LLC	400241	Agent - Health	3/1/2001	7/1/2006
Inactive	G.D.S. Group LLC	400241	Agent - Health Maintenance Organization	10/28/1999	3/1/2001