DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Fowler, Perry Milam	DOIID	389015	NAIC NPN	7208539

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	5/31/2001	10/1/2011
Inactive	Resident	Agent	Health	6/30/1997	10/1/2011
* 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	Forethought Life Insurance Company	301407	Agent - Life	6/19/2007	10/1/2011
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Health	6/30/1997	10/1/2011
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Life	5/31/2001	10/1/2011
Inactive	Lincoln Memorial Life Insurance Company	300463	Agent - Life	8/10/2004	4/28/2009
Inactive	Southland National Insurance Corporation	517954	Agent - Health	6/26/2009	7/17/2010
Inactive	Southland National Insurance Corporation	517954	Agent - Life	6/26/2009	7/17/2010
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	5/11/1990	6/9/1997

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Blair Insurance Agency Inc.	400381	Agent - Life	6/30/1997	11/20/1998
Inactive	Blair Insurance Agency Inc.	400381	Agent - Health	6/30/1997	11/20/1998
Inactive	Everidge & Hatten Inc	705349	Agent - Life	5/7/2009	3/31/2011