DEPARTMENT OF INSURANCE

Affiliations

Name	Bellomy, Gregory Scott	DOIID	375025	NAIC NPN	1725847

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	10/27/1992	7/1/2002
Inactive	Resident	Agent	Health Maintenance Organization	12/31/1998	11/1/2000
Inactive	Resident	Agent	Life	10/27/1992	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	Allianz Life Insurance Company of North America	301791	Agent - Health	9/17/1996	10/5/1999
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	9/17/1996	10/5/1999
Inactive	American Equity Investment Life Insurance Company	300389	Agent - Life	6/10/1999	1/12/2001
Inactive	American National Insurance Company	301861	Agent - Life	9/2/1994	7/1/2002
Inactive	Conseco Health Insurance Company	301725	Agent - Health	9/6/2000	7/1/2002
Inactive	Conseco Health Insurance Company	301725	Agent - Life	9/6/2000	7/1/2002
Inactive	First Colony Life Insurance Company	301179	Agent - Life	2/22/1996	8/13/2001
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	12/31/1998	11/1/2000
Inactive	Humana Insurance Company	301104	Agent - Health	12/31/1998	11/1/2000
Inactive	Humana Insurance Company	301104	Agent - Life	12/31/1998	11/1/2000
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	10/27/1992	9/29/2000
Inactive	LifeUSA Insurance Company	300386	Agent - Health	10/27/1992	7/1/2002
Inactive	LifeUSA Insurance Company	300386	Agent - Life	10/27/1992	7/1/2002
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	1/23/1996	8/13/2001
Inactive	Pioneer Life Insurance Company	300110	Agent - Health	4/20/1995	8/13/2001
Inactive	Pioneer Life Insurance Company	300110	Agent - Life	4/20/1995	8/13/2001
Inactive	Reassure America Life Insurance Company	301902	Agent - Health	1/10/1996	8/13/2001
Inactive	Reassure America Life Insurance Company	301902	Agent - Life	1/10/1996	8/13/2001
Inactive	Wilcac Life Insurance Company	301573	Agent - Health	1/10/1996	11/17/2000
Inactive	Wilcac Life Insurance Company	301573	Agent - Life	1/10/1996	11/17/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Frank Bradshaw Co	399179	Agent - Life	1/14/1993	12/1/2000
Inactive	Frank Bradshaw Co	399179	Agent - Health	1/14/1993	12/1/2000