DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Croucher, Mary L	DOIID	354101	NAIC NPN	2210102

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health Maintenance Organization	9/1/1995	9/21/2000
Inactive	Non Resident	Agent	Health	5/26/1995	1/16/2002
Inactive	Non Resident	Agent	Life	5/26/1995	1/16/2002
* 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	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health Maintenance Organization	11/14/1995	4/5/1999
Inactive	Anthem Life Insurance Company	301209	Agent - Health	5/26/1995	4/5/1999
Inactive	Anthem Life Insurance Company	301209	Agent - Life	5/26/1995	4/5/1999
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health Maintenance Organization	9/1/1995	9/21/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	6/15/1995	1/16/2002
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	6/15/1995	1/16/2002