DEPARTMENT OF INSURANCE

Affiliations

Name	Wallace, Larry	DOIID	358664	NAIC NPN	1489436

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Prepaid Dental Plan	7/15/1997	3/1/2001
Inactive	Resident	Agent	General Lines	3/28/1996	8/8/1996
Inactive	Resident	Agent	Life	8/3/1995	12/1/2000
Inactive	Resident	Agent	Health	8/3/1995	12/1/2000
* 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	Allianz Life Insurance Company of North America	301791	Agent - Health	5/6/1997	11/18/2000
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	5/6/1997	11/18/2000
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	6/12/1996	10/9/1998
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	6/12/1996	10/9/1998
Inactive	Anthem Life Insurance Company	301209	Agent - Health	3/22/1996	11/18/2000
Inactive	Anthem Life Insurance Company	301209	Agent - Life	3/22/1996	11/18/2000
Inactive	Canada Life Assurance Company	301192	Agent - Health	9/24/1996	7/24/2000
Inactive	Canada Life Assurance Company	301192	Agent - Life	9/24/1996	7/24/2000
Inactive	Celtic Insurance Company	300877	Agent - Health	7/3/1996	3/31/1997
Inactive	Celtic Insurance Company	300877	Agent - Life	7/3/1996	3/31/1997
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - General Lines	3/28/1996	8/8/1996
Inactive	Health Resources Inc.	301210	Agent - Health	3/1/2001	7/1/2002
Inactive	Health Resources Inc.	301210	Agent - Prepaid Dental Plan	7/15/1997	3/1/2001
Inactive	LifeUSA Insurance Company	300386	Agent - Health	5/6/1997	12/1/2000
Inactive	LifeUSA Insurance Company	300386	Agent - Life	5/6/1997	12/1/2000
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	8/3/1995	8/8/1996
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	8/3/1995	8/8/1996
Inactive	United American Insurance Company	300910	Agent - Health	6/19/1996	3/31/1997
Inactive	United American Insurance Company	300910	Agent - Life	6/19/1996	3/31/1997
Inactive	United Investors Life Insurance Company	301873	Agent - Life	8/14/1996	12/1/2000
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Health	6/4/1997	11/18/2000
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Life	6/4/1997	11/18/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Acordia Senior of The Southeast Inc.	401297	Agent - Life	3/7/1996	12/1/2000
Inactive	Acordia Senior of The Southeast Inc.	401297	Agent - Health	3/7/1996	12/1/2000
Inactive	Acordia of Western Kentucky Inc.	401302	Agent - Life	3/11/1996	12/1/2000
Inactive	Acordia of Western Kentucky Inc.	401302	Agent - Health	3/11/1996	12/1/2000