DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Forbes, Don Russell	DOIID	376971	NAIC NPN	7203226

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	4/23/1998	12/1/2000
* 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	9/12/1998	12/1/2000
Inactive	Combined Insurance Company of America	301472	Agent - Health	4/23/1998	9/24/1998

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Medlink Inc	400721	Agent - Health	11/23/1998	12/1/2000