DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Green, Keith E	DOIID	372315	NAIC NPN	2970887

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	10/10/2005	6/30/2011
Inactive	Non Resident	Agent	Health	10/10/2005	6/30/2011
* 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	11/21/2008	3/12/2010
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/21/2008	3/12/2010
Inactive	Minnesota Life Insurance Company	300488	Agent - Health	9/5/2000	2/12/2001
Inactive	Minnesota Life Insurance Company	300488	Agent - Life	9/5/2000	2/12/2001
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	3/2/2007	6/30/2011
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	3/2/2007	6/30/2011
Inactive	Stonebridge Life Insurance Company	301614	Agent - Health	9/5/2000	3/3/2003
Inactive	Stonebridge Life Insurance Company	301614	Agent - Life	9/5/2000	3/3/2003
Inactive	Wellpoint Life and Health Insurance Company	300469	Agent - Health	12/9/2008	2/23/2010
Inactive	Wellpoint Life and Health Insurance Company	300469	Agent - Life	12/9/2008	2/23/2010
Inactive	Work First Casualty Company	300561	Agent - Health	7/19/2000	3/12/2001

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Corporate Call Center, Inc	695480	Agent - Life	1/5/2009	3/26/2010
Inactive	Corporate Call Center, Inc	695480	Agent - Health	1/5/2009	3/26/2010
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/6/2008	7/31/2009
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/6/2008	7/31/2009