DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Peterson, Robert Raymond	DOIID	365140	NAIC NPN	7198109

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	3/27/2009	10/15/2010
Inactive	Resident	Agent	Life	3/27/2009	10/15/2010
Inactive	Resident	Agent	Limited Line Credit	8/7/2000	5/8/2001
Inactive	Resident	Agent	Credit Life & Health	10/17/1997	8/7/2000
* 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	Anthem Life Insurance Company	301209	Agent - Health	4/2/2009	10/15/2010
Inactive	Anthem Life Insurance Company	301209	Agent - Life	4/2/2009	10/15/2010
Inactive	Associates Financial Life Insurance Company	301765	Agent - Credit Life & Health	10/17/1997	3/30/2000
Inactive	Union Security Life Insurance Company	300903	Agent - Credit Life & Health	1/14/1998	8/7/2000
Inactive	Union Security Life Insurance Company	300903	Agent - Limited Line Credit	8/7/2000	5/8/2001

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CBISA Reaquisitian Corp	547026	Agent - Health	4/3/2009	8/31/2010
Inactive	CBISA Reaquisitian Corp	547026	Agent - Life	4/3/2009	8/31/2010