DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Lewis, Mark D	DOIID	364195	NAIC NPN	1498620

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	1/16/1996	8/7/1998
Inactive	Non Resident	Agent	Health	1/16/1996	8/7/1998
* 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	10/7/1996	6/24/1997
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/7/1996	6/24/1997
Inactive	Physicians Life Insurance Company	300924	Agent - Life	10/20/1997	8/7/1998
Inactive	Physicians Mutual Insurance Company	301084	Agent - Health	10/17/1997	8/7/1998
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	1/16/1996	3/31/1997
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	1/16/1996	3/31/1997

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 - Health	4/24/1996	6/24/1997
Inactive	Acordia Senior of The Southeast Inc.	401297	Agent - Life	4/24/1996	6/24/1997