DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Nichols III, George	DOIID	392012	NAIC NPN	7209647

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	4/20/1993	7/1/2002
Inactive	Resident	Agent	Life	4/20/1993	7/1/2002
Inactive	Resident	Agent	Health Maintenance Organization	1/22/1993	5/17/1996
* 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 Health Plans of Kentucky, Inc.	300999	Agent - Health Maintenance Organization	1/22/1993	5/17/1996
Inactive	Anthem Life Insurance Company	301209	Agent - Health	4/20/1993	5/6/1996
Inactive	Anthem Life Insurance Company	301209	Agent - Life	4/20/1993	5/6/1996
Inactive	NYLIFE Insurance Company of Arizona	301642	Agent - Health	4/9/2001	7/1/2002
Inactive	NYLIFE Insurance Company of Arizona	301642	Agent - Life	4/9/2001	7/1/2002
Inactive	New York Life Insurance Company	300431	Agent - Health	4/9/2001	7/1/2002
Inactive	New York Life Insurance Company	300431	Agent - Life	4/9/2001	7/1/2002
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Health	4/9/2001	7/1/2002
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Life	4/9/2001	7/1/2002

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	6/14/1993	5/6/1996
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	6/14/1993	5/6/1996