DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Provow, Charles Thomas	DOIID	381927	NAIC NPN	1676464

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	9/1/2011	2/28/2014
Inactive	Non Resident	Agent	Life	9/1/2011	2/28/2014
* 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	Anthem Life Insurance Company	301209	Agent - Health	9/14/1999	4/30/2004
Inactive	Anthem Life Insurance Company	301209	Agent - Life	9/14/1999	4/30/2004
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Health	12/12/2011	2/28/2014
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	12/12/2011	2/28/2014
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	9/19/2011	2/28/2014
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	9/19/2011	2/28/2014

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	9/20/1999	4/30/2004
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	9/20/1999	4/30/2004