DEPARTMENT OF INSURANCE

Affiliations

Name	Larsen, Brent Douglas	DOIID	365338	NAIC NPN	250073

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	12/9/1993	8/31/2006
Inactive	Non Resident	Agent	Life	12/9/1993	8/31/2006
* 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 Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	6/7/2000	8/31/2006
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	6/7/2000	8/31/2006
Inactive	Anthem Life Insurance Company	301209	Agent - Health	4/30/1998	12/1/2005
Inactive	Anthem Life Insurance Company	301209	Agent - Life	4/30/1998	12/1/2005
Inactive	Conseco Medical Insurance Company	300719	Agent - Health	1/23/1997	12/31/2000
Inactive	Conseco Medical Insurance Company	300719	Agent - Life	1/23/1997	12/31/2000
Inactive	Golden Rule Insurance Company	301943	Agent - Health	9/25/1997	11/12/1998
Inactive	Golden Rule Insurance Company	301943	Agent - Life	9/25/1997	11/12/1998
Inactive	John Alden Life Insurance Company	300573	Agent - Health	11/14/1994	3/31/1997
Inactive	John Alden Life Insurance Company	300573	Agent - Life	11/14/1994	3/31/1997
Inactive	Manhattan National Life Insurance Company	301011	Agent - Health	12/9/1993	4/9/2001
Inactive	Manhattan National Life Insurance Company	301011	Agent - Life	12/9/1993	4/9/2001
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	11/7/2001	2/10/2003
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	11/7/2001	2/10/2003
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	6/8/2000	5/12/2003
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	7/5/1995	3/31/1997
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	7/5/1995	3/31/1997
Inactive	Washington National Insurance Company	300587	Agent - Health	6/13/1995	6/21/1999
Inactive	Washington National Insurance Company	300587	Agent - Life	6/13/1995	6/21/1999
Inactive	Wellpoint Life and Health Insurance Company	300469	Agent - Health	6/5/2001	8/31/2006
Inactive	Wellpoint Life and Health Insurance Company	300469	Agent - Life	6/5/2001	8/31/2006

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	4/17/1998	8/31/2006
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	4/17/1998	8/31/2006