DEPARTMENT OF INSURANCE

Affiliations

Name	Cooper, Michael Wayne	DOIID	381634	NAIC NPN	1497586

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Life	1/7/1994	11/30/2004
Inactive	Resident	Agent	Health	1/7/1994	11/30/2004
Inactive	Resident	Agent	Health Maintenance Organization	3/25/1996	3/1/2001
* 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	4/15/1996	12/11/2002
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	4/15/1996	12/11/2002
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	6/27/2001	12/11/2002
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	6/27/2001	12/11/2002
Inactive	Centre Life Insurance Company	300341	Agent - Health	8/16/1994	3/31/1997
Inactive	Conseco Insurance Company	301202	Agent - Life	7/17/1997	12/11/2002
Inactive	Conseco Medical Insurance Company	300719	Agent - Health	12/30/1996	12/31/1998
Inactive	Conseco Medical Insurance Company	300719	Agent - Life	12/30/1996	12/31/1998
Inactive	First Colony Life Insurance Company	301179	Agent - Life	6/27/1995	12/11/2002
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Health	12/31/1998	12/11/2002
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Life	12/31/1998	12/11/2002
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Health	6/8/1995	3/31/1997
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Life	6/8/1995	3/31/1997
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	5/12/1998	11/30/2004
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	5/12/1998	11/30/2004
Inactive	Humana Insurance Company	301104	Agent - Health	7/24/1996	9/13/2002
Inactive	Humana Insurance Company	301104	Agent - Life	7/24/1996	9/13/2002
Inactive	John Alden Life Insurance Company	300573	Agent - Health	9/8/1995	3/31/1997
Inactive	John Alden Life Insurance Company	300573	Agent - Life	9/8/1995	3/31/1997
Inactive	Nassau Life Insurance Company	301406	Agent - Health	1/7/1994	8/16/1999
Inactive	Nassau Life Insurance Company	301406	Agent - Life	1/7/1994	8/16/1999
Inactive	PHL Variable Insurance Company	300525	Agent - Health	2/22/1995	8/16/1999
Inactive	PHL Variable Insurance Company	300525	Agent - Life	2/22/1995	8/16/1999
Inactive	PacifiCare Life Assurance Company	301082	Agent - Health	6/17/1998	7/31/2001
Inactive	PacifiCare Life Assurance Company	301082	Agent - Life	6/17/1998	7/31/2001
Inactive	PacifiCare of Ohio Inc.	301904	Agent - Health	3/1/2001	3/31/2001
Inactive	PacifiCare of Ohio Inc.	301904	Agent - Health Maintenance Organization	3/25/1996	3/1/2001
Inactive	Paul Revere Life Insurance Company	300971	Agent - Health	9/25/1995	11/30/2004
Inactive	Paul Revere Life Insurance Company	300971	Agent - Life	9/25/1995	11/30/2004
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	11/13/1997	10/24/2003
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	11/13/1997	10/24/2003
Inactive	Washington National Insurance Company	300587	Agent - Health	8/14/1995	3/31/1997
Inactive	Washington National Insurance Company	300587	Agent - Life	8/14/1995	3/31/1997

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	11/19/1996	6/19/2000
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	11/19/1996	6/19/2000