DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Green Jr, George	DOIID	392218	NAIC NPN	7209729

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	10/12/1995	1/12/1998
Inactive	Resident	Agent	Life	10/12/1995	1/12/1998
* 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	IA American Life Insurance Company	301149	Agent - Health	10/12/1995	10/11/1996
Inactive	IA American Life Insurance Company	301149	Agent - Life	10/12/1995	10/11/1996
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	4/25/1996	1/12/1998
Inactive	National States Insurance Company	300579	Agent - Health	2/22/1996	3/31/1997
Inactive	National States Insurance Company	300579	Agent - Life	2/22/1996	3/31/1997

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Cornerstone Senior Services LLC	399590	Agent - Life	8/26/1996	10/4/1996
Inactive	Cornerstone Senior Services LLC	399590	Agent - Health	8/26/1996	10/4/1996
Inactive	Liberty Insurance Agency Inc.	398620	Agent - Life	10/23/1995	1/12/1998
Inactive	Liberty Insurance Agency Inc.	398620	Agent - Health	10/23/1995	1/12/1998