DEPARTMENT OF INSURANCE

Affiliations

Name	Freeman, Douglas J	DOIID	343910	NAIC NPN	1827564

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Administrator	Not Applicable	10/15/1993	12/9/2009
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Medical Benefits Administrators Inc.	395813	Administrator - Not Applicable	10/15/1993	5/31/2003
Inactive	Vision Plus of America	395816	Administrator - Not Applicable	8/30/1999	5/31/2003