DEPARTMENT OF INSURANCE

Affiliations

Name	Fuller, Darrell Demone	DOIID	366878	NAIC NPN	7198861

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Prepaid Dental Plan	3/30/1992	3/1/2001
Pending	Resident	Agent	Health
Pending	Resident	Agent	Life
* 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	Aetna Health Inc.	300694	Agent - Health	12/13/2007	12/31/2007
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	12/31/2007	11/1/2008
Inactive	Aetna Life Insurance Company	301140	Agent - Health	12/13/2007	11/1/2008
Inactive	Aetna Life Insurance Company	301140	Agent - Life	12/13/2007	11/1/2008
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	6/8/2012	10/31/2012
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	6/8/2012	10/31/2012
Inactive	American General Life Insurance Company	301585	Agent - Health	12/31/2012	10/31/2016
Inactive	American General Life Insurance Company	301585	Agent - Life	12/31/2012	10/31/2016
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Health	9/25/2009	12/31/2012
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Life	9/25/2009	12/31/2012
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	11/15/2005	6/24/2008
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	11/15/2005	6/24/2008
Inactive	American United Life Insurance Company	300498	Agent - Health	11/10/2004	10/31/2007
Inactive	American United Life Insurance Company	300498	Agent - Life	11/10/2004	10/31/2007
Inactive	Anthem Life Insurance Company	301209	Agent - Health	12/5/2013	10/31/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	12/5/2013	10/31/2016
Inactive	Cincinnati Life Insurance Company (The)	300601	Agent - Health	12/2/2004	4/13/2006
Inactive	Cincinnati Life Insurance Company (The)	300601	Agent - Life	12/2/2004	4/13/2006
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	6/2/2009	10/31/2016
Inactive	CompBenefits Insurance Company	301864	Agent - Health	6/2/2009	7/2/2013
Inactive	CompBenefits Insurance Company	301864	Agent - Life	6/2/2009	7/2/2013
Inactive	CompDent Corporation	301387	Agent - Health	3/1/2001	7/1/2004
Inactive	CompDent Corporation	301387	Agent - Prepaid Dental Plan	3/30/1992	3/1/2001
Inactive	Companion Life Insurance Company	300191	Agent - Health	3/17/2008	11/1/2008
Inactive	Companion Life Insurance Company	300191	Agent - Life	3/17/2008	11/1/2008
Inactive	Dearborn Life Insurance Company	300401	Agent - Health	3/20/2008	11/1/2008
Inactive	Dearborn Life Insurance Company	300401	Agent - Life	3/20/2008	11/1/2008
Inactive	Dental Care Plus Inc.	301495	Agent - Health	5/27/2008	11/1/2008
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	6/2/2009	10/31/2016
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Health	3/4/2008	11/1/2008
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	3/4/2008	11/1/2008
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	8/8/2005	11/1/2008
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	8/8/2005	11/1/2008
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	6/2/2009	10/31/2016
Inactive	Humana Insurance Company	301104	Agent - Health	6/2/2009	10/31/2016
Inactive	Humana Insurance Company	301104	Agent - Life	6/2/2009	10/31/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/22/2011	10/31/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	8/24/2010	10/31/2016
Inactive	HumanaDental Insurance Company	301457	Agent - Health	6/2/2009	5/13/2013
Inactive	HumanaDental Insurance Company	301457	Agent - Life	6/2/2009	5/13/2013
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Health	11/2/2006	7/2/2007
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	11/2/2006	7/2/2007
Inactive	Kanawha Insurance Company	300127	Agent - Health	6/2/2009	10/31/2016
Inactive	Kanawha Insurance Company	300127	Agent - Life	6/2/2009	10/31/2016
Inactive	Kentucky Health Cooperative, Inc.	798780	Agent - Health	10/21/2013	10/29/2015
Inactive	Life Insurance Company of North America	300711	Agent - Health	6/12/2009	10/31/2016
Inactive	Life Insurance Company of North America	300711	Agent - Life	6/12/2009	10/31/2016
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	5/22/2009	11/16/2016
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	5/22/2009	11/16/2016
Inactive	Madison National Life Insurance Company Inc.	301458	Agent - Health	6/15/2009	10/31/2016
Inactive	Madison National Life Insurance Company Inc.	301458	Agent - Life	6/15/2009	10/31/2016
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	10/9/2009	12/14/2012
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	10/9/2009	12/14/2012
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	6/30/2011	10/31/2016
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	6/30/2011	10/31/2016
Inactive	Principal Life Insurance Company	300129	Agent - Health	2/27/2003	7/1/2004
Inactive	Principal Life Insurance Company	300129	Agent - Life	2/27/2003	7/1/2004
Inactive	Security Life Insurance Company of America	300936	Agent - Health	8/3/2001	3/11/2003
Inactive	Security Life Insurance Company of America	300936	Agent - Life	8/3/2001	3/11/2003
Inactive	Standard Insurance Company	300185	Agent - Health	12/1/2007	11/1/2008
Inactive	Standard Insurance Company	300185	Agent - Life	12/1/2007	11/1/2008
Inactive	Sun Life Assurance Company of Canada	301811	Agent - Health	10/23/2009	11/23/2010
Inactive	Sun Life Assurance Company of Canada	301811	Agent - Life	10/23/2009	11/23/2010
Inactive	Sun Life and Health Insurance Company (U.S.)	300801	Agent - Health	10/22/2009	11/23/2010
Inactive	Sun Life and Health Insurance Company (U.S.)	300801	Agent - Life	10/22/2009	11/23/2010
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	5/4/2009	11/27/2012
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	5/4/2009	11/27/2012
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Health	10/25/2005	12/22/2006
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Life	10/25/2005	12/22/2006
Inactive	Union Security Insurance Company	301844	Agent - Health	6/21/2002	7/1/2004
Inactive	Union Security Insurance Company	301844	Agent - Life	6/21/2002	7/1/2004
Inactive	United Heartland Life Insurance Company	517547	Agent - Health	11/15/2001	7/1/2004
Inactive	United Heartland Life Insurance Company	517547	Agent - Life	11/15/2001	7/1/2004
Inactive	United Wisconsin Insurance Company	301103	Agent - Health	11/15/2001	7/1/2004
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	6/23/2009	11/30/2016
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	6/23/2009	11/30/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	6/23/2009	11/30/2016
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	6/23/2009	11/30/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Assuredpartners Nl, Llc	762387	Agent - Life	9/26/2011	7/23/2012
Inactive	Assuredpartners Nl, Llc	762387	Agent - Health	9/26/2011	7/23/2012
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	5/22/2009	10/31/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/5/2013	10/31/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/5/2013	10/31/2016
Inactive	G H Brown & Co	400662	Agent - Life	2/19/2003	12/30/2003
Inactive	G H Brown & Co	400662	Agent - Health	2/19/2003	12/30/2003
Inactive	Garrett-Stotz Co	400616	Agent - Life	9/25/2013	10/14/2014
Inactive	Garrett-Stotz Co	400616	Agent - Health	9/25/2013	10/14/2014
Inactive	Iserve Advisors, LLC	657312	Agent - Life	6/22/2009	3/31/2013
Inactive	Iserve Advisors, LLC	657312	Agent - Health	6/22/2009	3/31/2013
Inactive	J.J.B. Hilliard, W.L. Lyons, LLC	679616	Agent - Life	1/26/2015	2/4/2016
Inactive	J.J.B. Hilliard, W.L. Lyons, LLC	679616	Agent - Health	1/26/2015	2/4/2016
Inactive	Neace Lukens, Inc.	398909	Agent - Life	6/22/2009	8/19/2012
Inactive	Neace Lukens, Inc.	398909	Agent - Health	6/22/2009	8/19/2012
Inactive	Planchoice Inc.	400482	Agent - Life	3/5/2003	7/1/2004
Inactive	Planchoice Inc.	400482	Agent - Health	3/5/2003	7/1/2004
Inactive	Thompson Associates Inc.	398584	Agent - Life	11/10/2004	3/22/2006
Inactive	Thompson Associates Inc.	398584	Agent - Health	11/10/2004	3/22/2006