DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Witherby, David Dale	DOIID	376041	NAIC NPN	7202832

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Credit Life & Health	12/18/1998	8/7/2000
Inactive	Resident	Agent	Life	4/5/2010	9/1/2011
Inactive	Resident	Agent	Limited Line Credit	8/7/2000	8/31/2007
Inactive	Resident	Agent	Health	4/5/2010	9/1/2011
* 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	Bankers Life and Casualty Company	300701	Agent - Health	2/26/2009	7/14/2009
Inactive	Bankers Life and Casualty Company	300701	Agent - Life	2/27/2009	7/14/2009
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Health	6/29/2009	2/5/2010
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	6/29/2009	2/5/2010
Inactive	Colonial Penn Life Insurance Company	300491	Agent - Health	3/30/2009	7/14/2009
Inactive	Colonial Penn Life Insurance Company	300491	Agent - Life	3/30/2009	7/14/2009
Inactive	Coventry Health and Life Insurance Company	301771	Agent - Health	3/26/2009	7/14/2009
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	3/26/2009	7/14/2009
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Limited Line Credit	10/16/2003	8/31/2007
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Limited Line Credit	9/26/2006	8/31/2007
Inactive	Southern Financial Life Insurance Company	300664	Agent - Credit Life & Health	12/18/1998	8/7/2000
Inactive	Southern Financial Life Insurance Company	300664	Agent - Limited Line Credit	8/7/2000	8/31/2007

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Don Jacobs Used Car Center, LLC	590462	Agent - Limited Line Credit	1/29/2007	8/31/2007
Inactive	Superior Acquisition, LLC	589615	Agent - Limited Line Credit	5/13/2004	8/31/2007
Inactive	Superior Nissan Inc.	399678	Agent - Credit Life & Health	4/29/1999	8/7/2000
Inactive	Superior Nissan Inc.	399678	Agent - Limited Line Credit	8/7/2000	5/31/2005