DEPARTMENT OF INSURANCE

Affiliations

Name	Mize, Carroll Richard	DOIID	376531	NAIC NPN	1467541

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	7/5/2019		7/31/2024
Active	Resident	Agent	Casualty	7/5/2019		7/31/2024
Active	Resident	Agent	Property	7/5/2019		7/31/2024
Active	Resident	Agent	Life	7/5/2019		7/31/2024
Inactive	Resident	Agent	Health Maintenance Organization	2/25/1997	3/1/2001
Inactive	Resident	Agent	General Lines	1/13/1995	8/15/2000
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	05/15/2024	07/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aetna Health Inc.	300694	Agent - Health	3/1/2001	10/24/2002
Inactive	Aetna Health Inc.	300694	Agent - Health Maintenance Organization	2/25/1997	3/1/2001
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	2/5/2001	11/21/2007
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	2/5/2001	11/21/2007
Inactive	AmTrust Insurance Company	300179	Agent - Casualty	8/15/2000	7/31/2008
Inactive	AmTrust Insurance Company	300179	Agent - General Lines	10/23/1995	8/15/2000
Inactive	AmTrust Insurance Company	300179	Agent - Property	8/15/2000	7/31/2008
Inactive	American Equity Investment Life Insurance Company	300389	Agent - Life	12/11/2000	7/31/2008
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	3/9/2018	8/6/2018
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	3/9/2018	8/6/2018
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	2/24/2006	7/31/2008
Inactive	American Fire and Casualty Company	300567	Agent - Property	2/24/2006	7/31/2008
Inactive	Centennial Life Insurance Company (The)	301561	Agent - Health	1/18/1996	3/31/1997
Inactive	Centennial Life Insurance Company (The)	301561	Agent - Life	1/18/1996	3/31/1997
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	9/8/2007	7/31/2008
Inactive	Consolidated Insurance Company	300943	Agent - Property	9/8/2007	7/31/2008
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	9/8/2010
Inactive	Emphesys Insurance Company	300598	Agent - Health	5/12/1994	3/31/1997
Inactive	Emphesys Insurance Company	300598	Agent - Life	5/12/1994	3/31/1997
Inactive	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	1/2/2002	10/17/2005
Inactive	First Colony Life Insurance Company	301179	Agent - Life	10/17/1995	7/14/2004
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Health	9/26/1995	10/28/1996
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Life	9/26/1995	10/28/1996
Inactive	Freedom Life Insurance Company of America	300074	Agent - Health	6/21/1994	3/31/1997
Inactive	Freedom Life Insurance Company of America	300074	Agent - Life	6/21/1994	3/31/1997
Inactive	Genworth Life Insurance Company	300623	Agent - Health	12/11/2001	12/4/2007
Inactive	Genworth Life Insurance Company	300623	Agent - Life	12/11/2001	12/4/2007
Inactive	Golden Rule Insurance Company	301943	Agent - Health	3/3/1995	11/12/1998
Inactive	Golden Rule Insurance Company	301943	Agent - Life	3/3/1995	11/12/1998
Inactive	Grange Indemnity Insurance Company	300793	Agent - Casualty	12/22/2016	7/31/2018
Inactive	Grange Indemnity Insurance Company	300793	Agent - Property	12/22/2016	7/31/2018
Inactive	Grange Insurance Company	300234	Agent - Casualty	12/22/2016	7/31/2018
Inactive	Grange Insurance Company	300234	Agent - General Lines	12/20/1996	8/15/2000
Inactive	Grange Insurance Company	300234	Agent - Property	12/22/2016	7/31/2018
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Casualty	12/22/2016	7/31/2018
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Property	12/22/2016	7/31/2018
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Casualty	1/23/2006	7/31/2008
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Property	1/23/2006	7/31/2008
Inactive	Hartford Casualty Insurance Company	301332	Agent - Casualty	1/23/2006	7/31/2008
Inactive	Hartford Casualty Insurance Company	301332	Agent - Property	1/23/2006	7/31/2008
Inactive	Hartford Fire Insurance Company	300628	Agent - Casualty	1/23/2006	7/31/2008
Inactive	Hartford Fire Insurance Company	300628	Agent - Property	1/23/2006	7/31/2008
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Casualty	1/23/2006	7/31/2008
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Property	1/23/2006	7/31/2008
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Casualty	1/23/2006	7/31/2008
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Property	1/23/2006	7/31/2008
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/15/2007	7/31/2008
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	7/14/1998	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	3/15/2007	7/31/2008
Inactive	Humana Insurance Company	301104	Agent - Life	3/15/2007	7/31/2008
Inactive	ING Insurance Company of America	301507	Agent - Life	3/5/1997	12/31/2002
Inactive	Indiana Insurance Company	301909	Agent - Casualty	9/8/2007	7/31/2008
Inactive	Indiana Insurance Company	301909	Agent - Property	9/8/2007	7/31/2008
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	1/12/2012	4/29/2014
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Health	6/8/1993	3/31/1997
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	6/8/1993	3/31/1997
Inactive	John Alden Life Insurance Company	300573	Agent - Health	12/15/2003	7/31/2008
Inactive	John Alden Life Insurance Company	300573	Agent - Life	12/15/2003	7/31/2008
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/10/2008	7/31/2008
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/10/2008	7/31/2008
Inactive	LifeUSA Insurance Company	300386	Agent - Health	6/20/1990	3/6/1996
Inactive	LifeUSA Insurance Company	300386	Agent - Life	6/20/1990	3/6/1996
Inactive	Manhattan National Life Insurance Company	301011	Agent - Health	10/27/1995	3/31/1997
Inactive	Manhattan National Life Insurance Company	301011	Agent - Life	10/27/1995	3/31/1997
Inactive	Meridian Mutual Insurance Company	301303	Agent - Casualty	8/15/2000	6/1/2001
Inactive	Meridian Mutual Insurance Company	301303	Agent - General Lines	1/13/1995	8/15/2000
Inactive	Meridian Mutual Insurance Company	301303	Agent - Property	8/15/2000	6/1/2001
Inactive	Midland National Life Insurance Company	300923	Agent - Health	4/17/1995	3/31/1997
Inactive	Midland National Life Insurance Company	300923	Agent - Life	4/17/1995	3/31/1997
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	9/8/2007	7/31/2008
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	9/8/2007	7/31/2008
Inactive	Northern Life Insurance Company	300301	Agent - Health	9/6/1995	6/5/1998
Inactive	Northern Life Insurance Company	300301	Agent - Life	9/6/1995	6/5/1998
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	2/24/2006	7/31/2008
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	2/24/2006	7/31/2008
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	2/24/2006	7/31/2008
Inactive	Ohio Security Insurance Company	300622	Agent - Property	2/24/2006	7/31/2008
Inactive	Ohio State Life Insurance Company (The)	300865	Agent - Life	5/15/1992	3/31/1997
Inactive	Omaha Insurance Company	751908	Agent - Health	9/29/2014	8/24/2015
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	11/2/2005	7/31/2008
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Life	11/2/2005	7/31/2008
Inactive	Pacific Life Insurance Company	301848	Agent - Life	7/15/1999	5/27/2003
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	9/8/2007	7/31/2008
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	9/8/2007	7/31/2008
Inactive	Peerless Insurance Company	301910	Agent - Casualty	9/8/2007	7/31/2008
Inactive	Peerless Insurance Company	301910	Agent - Property	9/8/2007	7/31/2008
Inactive	Peoples Benefit Life Insurance Company	301895	Agent - Life	7/18/2001	10/1/2007
Inactive	Pioneer Life Insurance Company	300110	Agent - Health	4/7/1995	8/25/2003
Inactive	Pioneer Life Insurance Company	300110	Agent - Life	4/7/1995	8/25/2003
Inactive	Security National Insurance Company	301151	Agent - Casualty	8/15/2000	7/31/2008
Inactive	Security National Insurance Company	301151	Agent - General Lines	10/23/1995	8/15/2000
Inactive	Security National Insurance Company	301151	Agent - Property	8/15/2000	7/31/2008
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Casualty	1/23/2006	7/31/2008
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Property	1/23/2006	7/31/2008
Inactive	Standard Life Insurance Company of Indiana	300116	Agent - Health	3/8/2002	7/31/2008
Inactive	Standard Life Insurance Company of Indiana	300116	Agent - Life	3/8/2002	7/31/2008
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Casualty	6/1/2001	1/2/2002
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Property	6/1/2001	1/2/2002
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Health	2/24/1997	7/31/2008
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	2/24/1997	7/31/2008
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Health	2/24/1997	7/31/2008
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Life	2/24/1997	7/31/2008
Inactive	Time Insurance Company	300683	Agent - Health	9/4/2001	7/31/2008
Inactive	Time Insurance Company	300683	Agent - Life	9/4/2001	7/31/2008
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	10/1/2005	7/31/2008
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	10/1/2005	7/31/2008
Inactive	Transamerica Life Insurance and Annuity Company	300148	Agent - Health	1/11/2002	10/1/2005
Inactive	Transamerica Life Insurance and Annuity Company	300148	Agent - Life	1/11/2002	10/1/2005
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Health	1/11/2002	7/31/2008
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Life	1/11/2002	7/31/2008
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	10/1/2007	7/31/2008
Inactive	Trinity Universal Insurance Company	300911	Agent - Casualty	8/15/2000	7/31/2008
Inactive	Trinity Universal Insurance Company	300911	Agent - General Lines	10/23/1995	8/15/2000
Inactive	Trinity Universal Insurance Company	300911	Agent - Property	8/15/2000	7/31/2008
Inactive	Trustgard Insurance Company	300104	Agent - Casualty	12/22/2016	7/31/2018
Inactive	Trustgard Insurance Company	300104	Agent - Property	12/22/2016	7/31/2018
Inactive	Twin City Fire Insurance Company	300721	Agent - Casualty	1/23/2006	7/31/2008
Inactive	Twin City Fire Insurance Company	300721	Agent - Property	1/23/2006	7/31/2008
Inactive	Union Security Insurance Company	301844	Agent - Health	3/9/1995	7/31/2008
Inactive	Union Security Insurance Company	301844	Agent - Life	3/9/1995	7/31/2008
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	2/22/1993	3/31/1997
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	2/22/1993	3/31/1997
Inactive	Voya Retirement Insurance and Annuity Company	300643	Agent - Health	3/5/1997	12/1/2006
Inactive	Voya Retirement Insurance and Annuity Company	300643	Agent - Life	3/5/1997	12/1/2006
Inactive	West American Insurance Company	301112	Agent - Casualty	2/24/2006	7/31/2008
Inactive	West American Insurance Company	301112	Agent - Property	2/24/2006	7/31/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	6/8/2000	5/10/2001
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	6/8/2000	5/10/2001
Inactive	Healthplan Services, Inc.	401230	Agent - Health	8/31/1995	3/31/1997
Inactive	Medlink Inc	400721	Agent - Life	5/16/2002	7/31/2008
Inactive	Medlink Inc	400721	Agent - Health	5/16/2002	7/31/2008
Inactive	World Marketing Alliance Inc.	398156	Agent - Life	2/5/1999	3/21/2003
Inactive	World Marketing Alliance Inc.	398156	Agent - Health	2/5/1999	3/21/2003