DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Puckett Sr, David B	DOIID	391747	NAIC NPN	1002070

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	6/10/1997	8/31/2004
Inactive	Non Resident	Agent	Life	6/10/1997	8/31/2004
* 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	First Colony Life Insurance Company	301179	Agent - Life	1/28/1999	7/14/2004
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	6/10/1997	12/30/2002
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	6/10/1997	12/30/2002
Inactive	Pacific Life Insurance Company	301848	Agent - Life	1/25/1999	5/8/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	VTX Agency Inc.	398130	Agent - Life	10/15/1997	1/20/2004
Inactive	VTX Agency Inc.	398130	Agent - Health	10/15/1997	12/30/2002