DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Diersing, Mary Ann	DOIID	360215	NAIC NPN	7195942

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	11/12/1996	1/1/2013
Inactive	Resident	Agent	Casualty	8/15/2000	1/1/2013
Inactive	Resident	Agent	Property	8/15/2000	1/1/2013
Inactive	Resident	Agent	Life	11/12/1996	1/1/2013
Inactive	Resident	Agent	General Lines	11/12/1996	8/15/2000
* 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	American Heritage Life Insurance Company	300272	Agent - Health	10/2/2000	7/19/2006
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	10/2/2000	7/19/2006
Inactive	FB Insurance Company (The)	301763	Agent - Casualty	8/15/2000	12/30/2011
Inactive	FB Insurance Company (The)	301763	Agent - General Lines	11/12/1996	8/15/2000
Inactive	FB Insurance Company (The)	301763	Agent - Property	8/15/2000	12/30/2011
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	7/2/2004	3/1/2012
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	7/2/2004	3/1/2012
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	1/12/2006	12/30/2009
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	1/12/2006	12/30/2009
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	9/19/2008	1/1/2013
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	9/19/2008	1/1/2013
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	8/15/2000	12/30/2011
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - General Lines	11/12/1996	8/15/2000
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	8/15/2000	12/30/2011
Inactive	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	11/12/1996	12/30/2011
Inactive	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	11/12/1996	12/30/2011
Inactive	Victoria Fire & Casualty Company	300313	Agent - Casualty	5/2/2011	1/1/2013
Inactive	Victoria Fire & Casualty Company	300313	Agent - Property	5/2/2011	1/1/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	12/14/2001	1/1/2013
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - General Lines	11/22/1996	8/15/2000
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Life	11/22/1996	1/3/2012
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Health	11/22/1996	1/3/2012
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Property	8/15/2000	1/3/2012
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Casualty	8/15/2000	1/3/2012