DEPARTMENT OF INSURANCE

Affiliations

Name	Fowler, William Thomas	DOIID	356329	NAIC NPN	1968816

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Variable Life and Variable Annuities	5/31/2001	12/31/2024
Active	Resident	Agent	Casualty	5/21/2015	12/31/2024
Active	Resident	Agent	Property	5/21/2015	12/31/2024
Active	Resident	Agent	Health	2/9/1999	12/31/2024
Active	Resident	Agent	Life	2/9/1999	12/31/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	10/15/2024	12/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aetna Health Inc.	300694	Agent - Health	2/3/2005	12/31/2007
Active	Aetna Health Inc. (PA)	660717	Agent - Health	12/31/2007
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/30/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	2/3/2005
Active	Aetna Life Insurance Company	301140	Agent - Life	2/3/2005
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	5/23/2005	11/21/2007
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	5/23/2005	11/21/2007
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Variable Life and Variable Annuities	5/23/2005	2/22/2016
Active	American Economy Insurance Company	300315	Agent - Casualty	11/9/2019
Active	American Economy Insurance Company	300315	Agent - Property	11/9/2019
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	6/28/2012
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	6/28/2012
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Variable Life and Variable Annuities	5/31/2001	2/15/2007
Active	American General Life Insurance Company	301585	Agent - Health	9/1/2004
Active	American General Life Insurance Company	301585	Agent - Life	9/1/2004
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Health	5/17/2001	9/19/2005
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Life	5/17/2001	9/19/2005
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Variable Life and Variable Annuities	5/31/2001	9/19/2005
Active	American Heritage Life Insurance Company	300272	Agent - Health	12/21/2004
Active	American Heritage Life Insurance Company	300272	Agent - Life	12/21/2004
Active	American United Life Insurance Company	300498	Agent - Health	4/20/2020
Active	American United Life Insurance Company	300498	Agent - Life	2/12/2019
Active	American United Life Insurance Company	300498	Agent - Variable Life and Variable Annuities	2/12/2019
Inactive	Ameritas Variable Life Insurance Company	300665	Agent - Life	8/16/2002	11/29/2006
Inactive	Ameritas Variable Life Insurance Company	300665	Agent - Variable Life and Variable Annuities	8/16/2002	11/29/2006
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	10/11/2017
Inactive	Assurity Life Insurance Company	301099	Agent - Health	8/10/2014	10/7/2014
Inactive	Assurity Life Insurance Company	301099	Agent - Life	8/10/2014	10/7/2014
Inactive	Athene Annuity and Life Company	301893	Agent - Life	6/17/2013	11/22/2021
Inactive	Augustar Life Assurance Corporation	301113	Agent - Health	4/21/2006	10/6/2010
Inactive	Augustar Life Assurance Corporation	301113	Agent - Life	4/21/2006	10/6/2010
Inactive	Augustar Life Insurance Company	301816	Agent - Health	4/21/2006	10/6/2010
Inactive	Augustar Life Insurance Company	301816	Agent - Life	4/21/2006	10/6/2010
Inactive	Brighthouse Life Insurance Company	301829	Agent - Health	7/15/1999	4/15/2005
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	7/15/1999	4/15/2005
Inactive	C.M. Life Insurance Company	301335	Agent - Health	10/6/2004	5/18/2007
Inactive	C.M. Life Insurance Company	301335	Agent - Life	10/6/2004	5/18/2007
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	3/9/2022
Active	ClearPath Insurance Company	979815	Agent - Casualty	2/29/2024
Inactive	Commonwealth Annuity and Life Insurance Company	300798	Agent - Health	10/22/2001	1/22/2009
Inactive	Commonwealth Annuity and Life Insurance Company	300798	Agent - Life	10/22/2001	1/22/2009
Inactive	Commonwealth Annuity and Life Insurance Company	300798	Agent - Variable Life and Variable Annuities	10/22/2001	1/22/2009
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	11/6/2009	3/14/2019
Inactive	CompBenefits Insurance Company	301864	Agent - Health	11/6/2009	11/23/2011
Inactive	CompBenefits Insurance Company	301864	Agent - Life	11/6/2009	11/23/2011
Inactive	Continental Casualty Company	301019	Agent - Health	10/7/2002	11/29/2004
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	6/15/2006	2/13/2007
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	6/15/2006	2/13/2007
Inactive	Delaware Life Insurance Company	301256	Agent - Life	3/15/2000	8/11/2003
Active	Dental Care Plus Inc.	301495	Agent - Health	12/1/2015
Active	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009
Inactive	Encova Life Insurance Company	301818	Agent - Life	2/17/2005	2/6/2007
Inactive	Equitable Financial Life Insurance Company	300808	Agent - Life	4/9/2001	8/4/2003
Inactive	Equitable Financial Life Insurance Company	300808	Agent - Variable Life and Variable Annuities	4/9/2001	8/4/2003
Inactive	Equitable Life Insurance Company of Iowa	301633	Agent - Life	4/13/2001	1/1/2004
Inactive	Equitable Life Insurance Company of Iowa	301633	Agent - Variable Life and Variable Annuities	4/13/2001	1/1/2004
Active	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	9/28/2018
Active	Farmers Property and Casualty Insurance Company	301237	Agent - Property	9/28/2018
Active	Fidelity Security Life Insurance Company	300466	Agent - Health	11/24/2015
Active	First Health Life & Health Insurance Company	301735	Agent - Health	1/18/2012
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	3/7/2018
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	3/7/2018
Inactive	Fortitude Life Insurance & Annuity Company	301503	Agent - Life	10/24/2005	12/24/2018
Inactive	Fortitude Life Insurance & Annuity Company	301503	Agent - Variable Life and Variable Annuities	10/24/2005	12/24/2018
Inactive	Genworth Life Insurance Company	300623	Agent - Health	3/16/2010	12/7/2012
Inactive	Genworth Life Insurance Company	300623	Agent - Life	3/16/2010	12/7/2012
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Health	2/7/2008	4/30/2009
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	2/7/2008	4/30/2009
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Variable Life and Variable Annuities	4/19/2001	5/23/2003
Inactive	Golden Rule Insurance Company	301943	Agent - Health	10/10/2013	7/10/2016
Inactive	Golden Rule Insurance Company	301943	Agent - Life	10/10/2013	7/10/2016
Inactive	Grange Indemnity Insurance Company	300793	Agent - Casualty	3/5/2018	2/24/2020
Inactive	Grange Indemnity Insurance Company	300793	Agent - Property	3/5/2018	2/24/2020
Inactive	Grange Insurance Company	300234	Agent - Casualty	3/5/2018	2/24/2020
Inactive	Grange Insurance Company	300234	Agent - Property	3/5/2018	2/24/2020
Inactive	Grange Life Insurance Company	300128	Agent - Health	2/20/2014	3/31/2021
Inactive	Grange Life Insurance Company	300128	Agent - Life	2/20/2014	12/30/2020
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Casualty	3/5/2018	2/24/2020
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Property	3/5/2018	2/24/2020
Inactive	Guardian Insurance & Annuity Company Inc. (The)	301920	Agent - Life	7/15/2002	6/19/2006
Inactive	Guardian Insurance & Annuity Company Inc. (The)	301920	Agent - Variable Life and Variable Annuities	7/15/2002	7/28/2006
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014
Active	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/4/2018
Active	Humana Health Plan, Inc.	300142	Agent - Health	1/3/2006
Active	Humana Insurance Company	301104	Agent - Health	11/4/2003
Active	Humana Insurance Company	301104	Agent - Life	11/4/2003
Active	Humana Insurance Company of Kentucky	300826	Agent - Health	1/3/2006
Active	Humana Insurance Company of Kentucky	300826	Agent - Life	1/3/2006
Active	Humana Medical Plan, Inc.	801568	Agent - Health	12/15/2014
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	12/5/2016
Inactive	Integrity Life Insurance Company	301687	Agent - Health	5/25/2001	11/14/2008
Inactive	Integrity Life Insurance Company	301687	Agent - Life	5/25/2001	11/9/2010
Inactive	Integrity Life Insurance Company	301687	Agent - Variable Life and Variable Annuities	8/20/2001	11/9/2010
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	4/11/2011	11/30/2018
Inactive	Jackson National Life Insurance Company	300486	Agent - Variable Life and Variable Annuities	4/11/2011	11/30/2018
Inactive	Jefferson National Life Insurance Company	300258	Agent - Life	2/21/2005	6/8/2006
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	4/30/2001	6/7/2008
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	4/30/2001	6/7/2008
Inactive	John Hancock Life Insurance Company	300821	Agent - Variable Life and Variable Annuities	5/31/2001	6/7/2008
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	1/29/2010	4/2/2013
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	4/9/2009	4/2/2013
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Variable Life and Variable Annuities	4/9/2009	4/2/2013
Inactive	John Hancock Variable Life Insurance Company	301914	Agent - Health	4/30/2001	12/11/2006
Inactive	John Hancock Variable Life Insurance Company	301914	Agent - Life	4/30/2001	12/11/2006
Inactive	John Hancock Variable Life Insurance Company	301914	Agent - Variable Life and Variable Annuities	5/31/2001	12/20/2006
Inactive	Kanawha Insurance Company	300127	Agent - Health	11/6/2009	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	11/6/2009	10/22/2015
Inactive	Kentucky Health Cooperative, Inc.	798780	Agent - Health	10/7/2013	10/29/2015
Inactive	Keyport Life Insurance Company	300319	Agent - Life	5/12/1999	5/28/1999
Inactive	Life Insurance Company of the Southwest	301867	Agent - Health	4/27/2011	3/1/2019
Inactive	Life Insurance Company of the Southwest	301867	Agent - Life	4/27/2011	3/1/2019
Inactive	Lincoln Benefit Life Company	301110	Agent - Health	7/12/2002	1/27/2005
Inactive	Lincoln Benefit Life Company	301110	Agent - Life	7/12/2002	1/27/2005
Inactive	Lincoln Benefit Life Company	301110	Agent - Variable Life and Variable Annuities	7/12/2002	1/27/2005
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Health	6/29/2007
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Life	6/29/2007
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Variable Life and Variable Annuities	6/29/2007	12/27/2016
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Health	10/6/2004	5/18/2007
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Life	10/6/2004	5/18/2007
Inactive	MedAmerica Insurance Company	301568	Agent - Health	2/18/2004	3/6/2009
Inactive	MetLife Investors Insurance Company	301872	Agent - Life	8/16/2002	7/28/2003
Inactive	MetLife Investors Insurance Company	301872	Agent - Variable Life and Variable Annuities	8/16/2002	7/28/2003
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	7/5/2002	7/28/2003
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Variable Life and Variable Annuities	7/5/2002	7/28/2003
Inactive	MetLife Life and Annuity Company of Connecticut	301593	Agent - Health	7/15/1999	4/15/2005
Inactive	MetLife Life and Annuity Company of Connecticut	301593	Agent - Life	7/15/1999	4/15/2005
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	12/12/2008	12/16/2014
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	12/12/2008	12/16/2014
Active	Milbank Insurance Company	925185	Agent - Casualty	3/6/2020
Active	Milbank Insurance Company	925185	Agent - Property	3/6/2020
Inactive	Nassau Life Insurance Company	301406	Agent - Health	5/9/2001	2/13/2004
Inactive	Nassau Life Insurance Company	301406	Agent - Life	5/9/2001	2/13/2004
Inactive	Nassau Life Insurance Company	301406	Agent - Variable Life and Variable Annuities	5/9/2001	2/13/2004
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	12/21/2014	12/12/2016
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	12/21/2014	12/12/2016
Inactive	Nationwide Life Insurance Company	300495	Agent - Variable Life and Variable Annuities	12/21/2014	12/12/2016
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	10/20/2006	1/4/2008
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Variable Life and Variable Annuities	10/20/2006	1/4/2008
Inactive	North American Company for Life and Health Insurance	300291	Agent - Health	8/28/2012	4/22/2019
Inactive	North American Company for Life and Health Insurance	300291	Agent - Life	8/6/2012	4/22/2019
Inactive	Northbrook Life Insurance Company	301020	Agent - Life	5/18/1999	3/4/2002
Inactive	PHL Variable Insurance Company	300525	Agent - Health	5/9/2001	12/8/2008
Inactive	PHL Variable Insurance Company	300525	Agent - Life	5/9/2001	12/11/2007
Inactive	PHL Variable Insurance Company	300525	Agent - Variable Life and Variable Annuities	5/31/2001	12/11/2007
Inactive	Pacific Life Insurance Company	301848	Agent - Variable Life and Variable Annuities	5/31/2001	3/13/2017
Inactive	Pan-American Life Insurance Company	301530	Agent - Health	1/5/2004	10/9/2007
Inactive	Pan-American Life Insurance Company	301530	Agent - Life	1/5/2004	10/9/2007
Inactive	Principal Life Insurance Company	300129	Agent - Health	11/15/2002	11/25/2009
Inactive	Principal Life Insurance Company	300129	Agent - Life	11/15/2002	11/25/2009
Inactive	Principal Life Insurance Company	300129	Agent - Variable Life and Variable Annuities	5/19/2008	11/25/2009
Inactive	Protective Life Insurance Company	300638	Agent - Health	12/5/2003	6/8/2006
Inactive	Protective Life Insurance Company	300638	Agent - Life	12/5/2003	6/8/2006
Inactive	Protective Life Insurance Company	300638	Agent - Variable Life and Variable Annuities	10/6/2005	6/8/2006
Inactive	Pruco Life Insurance Company	300954	Agent - Health	10/2/2009	12/24/2018
Inactive	Pruco Life Insurance Company	300954	Agent - Life	10/2/2009	12/24/2018
Inactive	Pruco Life Insurance Company	300954	Agent - Variable Life and Variable Annuities	10/2/2009	12/24/2018
Inactive	Reassure America Life Insurance Company	301902	Agent - Health	9/5/2002	9/3/2004
Inactive	Reassure America Life Insurance Company	301902	Agent - Life	9/5/2002	9/3/2004
Inactive	Reliance Standard Life Insurance Company	300584	Agent - Health	8/7/2018	6/14/2022
Inactive	Reliance Standard Life Insurance Company	300584	Agent - Life	8/7/2018	6/14/2022
Active	SAFECO Insurance Company of America	300159	Agent - Casualty	3/12/2018
Active	SAFECO Insurance Company of America	300159	Agent - Property	3/12/2018
Active	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	3/12/2018
Active	SAFECO Insurance Company of Illinois	301350	Agent - Property	3/12/2018
Active	SilverScript Insurance Company	663526	Agent - Health	4/29/2016
Inactive	Standard Insurance Company	300185	Agent - Health	7/27/2007	12/5/2022
Inactive	Standard Insurance Company	300185	Agent - Life	7/27/2007	12/5/2022
Inactive	SunAmerica Annuity and Life Assurance Company	301930	Agent - Life	4/26/2001	3/6/2006
Inactive	SunAmerica Annuity and Life Assurance Company	301930	Agent - Variable Life and Variable Annuities	5/31/2001	3/6/2006
Inactive	SunAmerica Life Insurance Company	300096	Agent - Life	4/26/2001	3/31/2003
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Health	2/9/1999	11/16/2011
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	2/9/1999	11/16/2011
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Variable Life and Variable Annuities	5/31/2001	11/16/2011
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Health	2/9/1999	11/16/2011
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Life	2/9/1999	11/16/2011
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Variable Life and Variable Annuities	5/31/2001	11/16/2011
Inactive	Time Insurance Company	300683	Agent - Health	11/10/2014	11/25/2019
Inactive	Time Insurance Company	300683	Agent - Life	11/10/2014	11/25/2019
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	4/30/2001	6/24/2003
Inactive	Transamerica Life Insurance Company	300571	Agent - Variable Life and Variable Annuities	4/30/2001	6/24/2003
Inactive	Transamerica Life Insurance and Annuity Company	300148	Agent - Health	12/3/2001	9/21/2005
Inactive	Transamerica Life Insurance and Annuity Company	300148	Agent - Life	4/30/2001	7/11/2003
Inactive	Transamerica Life Insurance and Annuity Company	300148	Agent - Variable Life and Variable Annuities	4/30/2001	7/11/2003
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Health	12/3/2001	7/11/2003
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Life	4/30/2001	7/11/2003
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Variable Life and Variable Annuities	4/30/2001	7/11/2003
Inactive	Trustgard Insurance Company	300104	Agent - Casualty	3/5/2018	2/24/2020
Inactive	Trustgard Insurance Company	300104	Agent - Property	3/5/2018	2/24/2020
Inactive	Union Central Life Insurance Company	300307	Agent - Life	9/6/2006	12/27/2007
Active	United of Omaha Life Insurance Company	300156	Agent - Health	9/18/2018
Active	United of Omaha Life Insurance Company	300156	Agent - Life	9/18/2018
Active	United of Omaha Life Insurance Company	300156	Agent - Variable Life and Variable Annuities	3/7/2024
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	6/16/2004	12/14/2009
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	6/16/2004	12/14/2009
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	8/18/2015	7/10/2016
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	6/16/2004	12/14/2009
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Life	4/9/2001	3/15/2010
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Variable Life and Variable Annuities	5/31/2001	3/15/2010
Inactive	WellCare Health Insurance of Arizona, Inc.	501692	Agent - Health	11/16/2008	4/29/2010
Inactive	WellCare Health Insurance of Arizona, Inc.	501692	Agent - Life	11/16/2008	4/29/2010
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	4/9/2019	5/14/2021
Inactive	West Coast Life Insurance Company	301607	Agent - Health	12/31/2007	11/23/2009
Inactive	West Coast Life Insurance Company	301607	Agent - Life	12/31/2007	11/23/2009
Inactive	Western National Life Insurance Company	300461	Agent - Life	8/16/2002	12/31/2012
Inactive	Western Reserve Life Assurance Company of Ohio	300760	Agent - Health	5/15/2003	2/12/2008
Inactive	Western Reserve Life Assurance Company of Ohio	300760	Agent - Life	5/15/2003	2/12/2008
Inactive	Western Reserve Life Assurance Company of Ohio	300760	Agent - Variable Life and Variable Annuities	5/15/2003	2/12/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Dental Choice Agency Inc.	398085	Agent - Health	4/6/2005
Active	Designated Agent Company Inc.	681257	Agent - Life	12/9/2013
Active	Designated Agent Company Inc.	681257	Agent - Health	12/9/2013
Active	FSAB, LLC	576450	Agent - Life	9/19/2003
Active	FSAB, LLC	576450	Agent - Health	9/19/2003
Active	FSAB, LLC	576450	Agent - Property	4/12/2018
Active	FSAB, LLC	576450	Agent - Casualty	4/12/2018
Inactive	Medlink Inc	400721	Agent - Life	12/3/2003	3/31/2024
Inactive	Medlink Inc	400721	Agent - Health	12/3/2003	3/31/2024
Inactive	Morgan Keegan & Company Inc.	398102	Agent - Life	2/21/2003	1/8/2004
Inactive	Morgan Keegan & Company Inc.	398102	Agent - Health	2/21/2003	1/8/2004
Inactive	Morgan Keegan & Company Inc.	398102	Agent - Variable Life and Variable Annuities	2/21/2003	1/8/2004