DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Carrell, David W	DOIID	346657	NAIC NPN	1512736

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	9/4/1997	7/31/2012
Inactive	Non Resident	Agent	Life	9/4/1997	7/31/2012
Inactive	Non Resident	Life & Health Consultant	Not Applicable	1/26/1999	6/12/2003
* 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	CIGNA Health & Life Insurance Company	301783	Agent - Health	9/4/1997	11/7/2003
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Life	9/4/1997	11/7/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Gallagher Benefit Services Inc	525782	Agent - Life
Denied	Gallagher Benefit Services Inc	525782	Agent - Health