DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Gapen, Michael S	DOIID	358956	NAIC NPN	7195400

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	6/24/1999	7/1/2002
Inactive	Resident	Agent	Health	6/24/1999	7/1/2002
Inactive	Resident	Agent	Casualty	12/7/2015	12/1/2018
Inactive	Resident	Agent	Property	12/7/2015	12/1/2018
Inactive	Resident	Temporary Agent	Ordinary Life (Temporary Life)	3/5/1999	6/24/1999
* 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	Genworth Life Insurance Company	300623	Agent - Health	6/12/2000	7/1/2002
Inactive	Genworth Life Insurance Company	300623	Agent - Life	6/12/2000	7/1/2002
Inactive	Liberty Life Insurance Company	301542	Agent - Health	8/13/1999	7/1/2002
Inactive	Liberty Life Insurance Company	301542	Agent - Life	8/13/1999	7/1/2002
Inactive	Life Insurance Company of the Southwest	301867	Agent - Life	7/27/2001	7/1/2002
Inactive	LifeUSA Insurance Company	300386	Agent - Health	1/5/2000	5/30/2000
Inactive	LifeUSA Insurance Company	300386	Agent - Life	1/5/2000	5/30/2000
Inactive	NYLIFE Insurance Company of Arizona	301642	Agent - Health	6/24/1999	7/30/1999
Inactive	NYLIFE Insurance Company of Arizona	301642	Agent - Life	6/24/1999	7/30/1999
Inactive	New Hampshire Insurance Company	301670	Agent - Casualty	3/22/2016	1/3/2017
Inactive	New Hampshire Insurance Company	301670	Agent - Property	3/22/2016	1/3/2017
Inactive	New York Life Insurance Company	300431	Agent - Health	6/24/1999	3/19/2001
Inactive	New York Life Insurance Company	300431	Agent - Life	6/24/1999	3/19/2001
Inactive	New York Life Insurance Company	300431	Temporary Agent - Ordinary Life (Temporary Life)	3/5/1999	6/24/1999
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Health	6/24/1999	7/30/1999
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Life	6/24/1999	7/30/1999
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	11/3/1999	7/1/2002
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	11/3/1999	7/1/2002

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Medlink Inc	400721	Agent - Life	1/25/2002	7/1/2002
Inactive	Medlink Inc	400721	Agent - Health	1/25/2002	7/1/2002
Inactive	Metlife Pet Insurance Solutions LLC	620620	Agent - Casualty	6/24/2016	11/17/2016
Inactive	Metlife Pet Insurance Solutions LLC	620620	Agent - Property	6/24/2016	11/17/2016