DEPARTMENT OF INSURANCE

Affiliations

Name	Wallace Jr, Thomas Lee	DOIID	390721	NAIC NPN	705076

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	5/20/2005	11/30/2009
Inactive	Non Resident	Agent	Life	5/20/2005	11/30/2009
* 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	American Heritage Life Insurance Company	300272	Agent - Health	3/17/1999	8/28/2003
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	3/17/1999	8/28/2003
Inactive	Assurity Life Insurance Company	301099	Agent - Health	6/13/2006	12/14/2006
Inactive	Assurity Life Insurance Company	301099	Agent - Life	6/13/2006	12/14/2006
Inactive	Bankers United Life Assurance Company	300296	Agent - Health	7/5/2001	12/31/2001
Inactive	Bankers United Life Assurance Company	300296	Agent - Life	7/5/2001	12/31/2001
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Health	5/17/2000	10/16/2003
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	5/17/2000	10/16/2003
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	4/9/2008	11/30/2009
Inactive	CompBenefits Insurance Company	301864	Agent - Health	4/9/2008	11/30/2009
Inactive	CompBenefits Insurance Company	301864	Agent - Life	4/9/2008	11/30/2009
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	11/30/2009
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	4/9/2008	11/30/2009
Inactive	Humana Insurance Company	301104	Agent - Health	4/9/2008	11/30/2009
Inactive	Humana Insurance Company	301104	Agent - Life	4/9/2008	11/30/2009
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	4/9/2008	11/30/2009
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	4/9/2008	11/30/2009
Inactive	HumanaDental Insurance Company	301457	Agent - Health	4/9/2008	11/30/2009
Inactive	HumanaDental Insurance Company	301457	Agent - Life	4/9/2008	11/30/2009
Inactive	Life Investors Insurance Company of America	301793	Agent - Health	12/31/2001	9/19/2003
Inactive	Life Investors Insurance Company of America	301793	Agent - Life	12/31/2001	9/19/2003
Inactive	Principal Life Insurance Company	300129	Agent - Health	8/6/1999	10/16/2003
Inactive	Principal Life Insurance Company	300129	Agent - Life	8/6/1999	10/16/2003
Inactive	Protective Life Insurance Company	300638	Agent - Health	9/22/1999	10/16/2003
Inactive	Protective Life Insurance Company	300638	Agent - Life	9/22/1999	10/16/2003
Inactive	Transamerica Assurance Company	300893	Agent - Health	7/5/2001	10/28/2003
Inactive	Transamerica Assurance Company	300893	Agent - Life	7/5/2001	10/28/2003
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	7/5/2001	10/28/2003
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	7/5/2001	10/28/2003
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	1/6/2006	12/30/2009
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	1/6/2006	12/30/2009
Inactive	Union Security Insurance Company	301844	Agent - Health	2/7/2002	10/16/2003
Inactive	Union Security Insurance Company	301844	Agent - Life	2/7/2002	10/16/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	BenCom, LLC	654880	Agent - Life	5/18/2007	3/31/2009
Inactive	BenCom, LLC	654880	Agent - Health	5/18/2007	3/31/2009