DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Pottlitzer, B Todd	DOIID	355204	NAIC NPN	7193768

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	3/28/1994	7/1/1996
Inactive	Resident	Agent	Credit Life & Health	1/27/1995	11/23/1996
* 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	Banc One Kentucky Insurance Company	300824	Agent - Credit Life & Health	4/5/1995	11/23/1996
Inactive	Keyport Life Insurance Company	300319	Agent - Life	4/28/1994	7/1/1996
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	3/28/1994	7/1/1996

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bank One Lexington NA	399387	Agent - Credit Life & Health	1/27/1995	11/23/1996