DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Shupe, Mark Thomas	DOIID	368836	NAIC NPN	7199688

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	3/4/1988	7/1/2002
Inactive	Resident	Agent	Life	3/4/1988	7/1/2002
* 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	Connecticut General Life Insurance Company	301333	Agent - Health	8/1/1997	4/16/2001
Inactive	Connecticut General Life Insurance Company	301333	Agent - Life	8/1/1997	4/16/2001
Inactive	Conseco Insurance Company	301202	Agent - Health	10/3/1990	7/1/2002
Inactive	Conseco Insurance Company	301202	Agent - Life	10/3/1990	7/1/2002
Denied	Everlake Life Insurance Company	300873	Agent - Life
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	2/11/1998	7/1/2002
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	2/11/1998	7/1/2002
Inactive	Keyport Life Insurance Company	300319	Agent - Health	10/3/1990	7/1/2002
Inactive	Keyport Life Insurance Company	300319	Agent - Life	10/3/1990	7/1/2002
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	7/31/1992	7/1/2002
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	7/31/1992	7/1/2002
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	8/15/1990	7/1/2002
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	8/15/1990	7/1/2002
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	5/2/2001	7/1/2002
Inactive	Northbrook Life Insurance Company	301020	Agent - Life	6/25/2001	7/1/2002
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Health	7/29/1999	7/1/2002
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	7/29/1999	7/1/2002
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Life	9/29/1994	7/1/2002

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bache Ins of KY Inc	400226	Agent - Life	3/4/1988	7/1/2002
Inactive	Bache Ins of KY Inc	400226	Agent - Health	3/4/1988	7/1/2002