DEPARTMENT OF INSURANCE

Affiliations

Name	Willoughby, David	DOIID	362988	NAIC NPN	7197185

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	5/16/1994	7/1/2004
Inactive	Resident	Agent	Life	4/7/1994	7/1/2004
Inactive	Resident	Agent	Health Maintenance Organization	4/25/1997	3/1/2001
* 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	1/17/2002	7/1/2004
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	1/17/2002	7/1/2004
Inactive	American Investors Life Insurance Company, Inc.	301358	Agent - Life	6/5/1996	10/26/1998
Inactive	Centennial Life Insurance Company (The)	301561	Agent - Health	3/14/1996	3/31/1997
Inactive	Centennial Life Insurance Company (The)	301561	Agent - Life	3/14/1996	3/31/1997
Inactive	Continental General Insurance Company	300691	Agent - Health	10/5/1998	7/19/1999
Inactive	Continental General Insurance Company	300691	Agent - Life	10/5/1998	7/19/1999
Inactive	Genworth Life Insurance Company	300623	Agent - Health	9/15/2000	12/22/2003
Inactive	Genworth Life Insurance Company	300623	Agent - Life	9/15/2000	12/22/2003
Inactive	Golden Rule Insurance Company	301943	Agent - Health	8/1/1994	3/31/1997
Inactive	Golden Rule Insurance Company	301943	Agent - Life	8/1/1994	3/31/1997
Inactive	Liberty Life Insurance Company	301542	Agent - Health	7/2/1998	3/12/2001
Inactive	Liberty Life Insurance Company	301542	Agent - Life	7/2/1998	3/12/2001
Inactive	Life Insurance Company of Alabama	301439	Agent - Health	3/31/1997	7/1/2004
Inactive	Life Insurance Company of Alabama	301439	Agent - Life	3/31/1997	7/1/2004
Inactive	Life Investors Insurance Company of America	301793	Agent - Health	5/30/1995	3/31/1997
Inactive	Life Investors Insurance Company of America	301793	Agent - Life	5/30/1995	3/31/1997
Inactive	LifeSecure Insurance Company	301629	Agent - Health	5/14/1997	11/30/1998
Inactive	LifeSecure Insurance Company	301629	Agent - Life	5/14/1997	11/30/1998
Inactive	Midland National Life Insurance Company	300923	Agent - Health	10/22/1997	1/29/1998
Inactive	Midland National Life Insurance Company	300923	Agent - Life	10/22/1997	1/29/1998
Inactive	Modern Woodmen of America	301213	Agent - Life	4/7/1994	5/22/1996
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	5/28/2002	9/23/2003
Inactive	Philadelphia American Life Insurance Company	300178	Agent - Health	8/1/1995	3/31/1997
Inactive	Philadelphia American Life Insurance Company	300178	Agent - Life	8/1/1995	3/31/1997
Inactive	Southern Security Life Insurance Company	300651	Agent - Life	5/24/1996	12/21/1998
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	3/1/2001	7/1/2004
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health Maintenance Organization	4/25/1997	3/1/2001
Inactive	Western and Southern Life Insurance Company	301744	Agent - Health	12/22/2000	1/3/2003
Inactive	Western and Southern Life Insurance Company	301744	Agent - Life	12/22/2000	1/3/2003
Inactive	Western-Southern Life Assurance Company	301590	Agent - Health	12/15/2000	1/3/2003
Inactive	Western-Southern Life Assurance Company	301590	Agent - Life	12/22/2000	1/3/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	6/25/1996	2/28/2003
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	6/25/1996	2/28/2003
Inactive	Medlink Inc	400721	Agent - Life	11/23/1998	7/1/2004
Inactive	Medlink Inc	400721	Agent - Health	11/23/1998	7/1/2004