DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Gould, Jan Lee	DOIID	362048	NAIC NPN	7196756

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	6/11/1991	4/1/2011
Inactive	Resident	Agent	Life	6/11/1991	4/1/2011
* 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	Anthem Life Insurance Company	301209	Agent - Health	7/26/1993	4/1/2011
Inactive	Anthem Life Insurance Company	301209	Agent - Life	7/23/1993	4/1/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Kentucky Retail Federation Insurance Agency	400706	Agent - Life	6/2/2010	4/1/2011
Inactive	Kentucky Retail Federation Insurance Agency	400706	Agent - Health	6/2/2010	4/1/2011