DEPARTMENT OF INSURANCE

Affiliations

Name	Roettker, David Robert	DOIID	365914	NAIC NPN	1492164

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	5/31/2001	12/31/2003
Inactive	Non Resident	Agent	Health	8/15/1995	12/31/2003
* 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	Equitable Life Insurance Company of Iowa	301633	Agent - Health	5/21/2001	12/31/2003
Inactive	Equitable Life Insurance Company of Iowa	301633	Agent - Life	5/21/2001	12/31/2003
Inactive	Everlake Life Insurance Company	300873	Agent - Life	4/17/2000	4/2/2003
Inactive	First Colony Life Insurance Company	301179	Agent - Life	6/12/1992	3/31/1997
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Health	6/17/1998	12/31/2003
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Life	6/17/1998	12/31/2003
Inactive	Fortitude Life Insurance & Annuity Company	301503	Agent - Life	9/27/1999	12/31/2003
Inactive	Jackson National Life Insurance Company	300486	Agent - Health	6/3/1996	12/31/2003
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	6/3/1996	12/31/2003
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	1/19/1996	4/5/2001
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	1/19/1996	4/5/2001
Inactive	MML Bay State Life Insurance Company	301198	Agent - Health	8/12/1996	12/31/2003
Inactive	MML Bay State Life Insurance Company	301198	Agent - Life	8/12/1996	12/31/2003
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	8/15/1995	12/31/2003
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	8/15/1995	12/31/2003
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	8/15/1995	4/10/2001
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	8/15/1995	4/10/2001
Inactive	Security Benefit Life Insurance Company	300583	Agent - Health	8/25/1995	12/31/2003
Inactive	Security Benefit Life Insurance Company	300583	Agent - Life	8/25/1995	12/31/2003
Inactive	Union Security Insurance Company	301844	Agent - Life	9/14/1999	12/31/2003
Inactive	Zurich American Life Insurance Company	300216	Agent - Life	2/23/1999	12/31/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Donahue Securities Inc.	398694	Agent - Life	5/16/1996	5/31/2003