DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Mittan Jr, Raymond Delbert	DOIID	393158	NAIC NPN	355364

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	12/30/2013	5/31/2015
Inactive	Non Resident	Agent	Prepaid Dental Plan	4/26/1996	8/9/1999
Inactive	Non Resident	Agent	Life	9/15/1992	7/31/2003
* 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 Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	9/15/1992	1/11/1999
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	9/15/1992	1/11/1999
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	5/18/1998	7/31/2003
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	5/18/1998	7/31/2003
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	2/1/2014	5/31/2015
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Health	3/23/1999	7/31/2003
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	3/23/1999	7/31/2003
Inactive	CompDent Corporation	301387	Agent - Prepaid Dental Plan	4/26/1996	8/9/1999
Inactive	Fidelity Life Association, A Legal Reserve Life Insurance Company	300774	Agent - Health	3/23/1999	7/31/2003
Inactive	Fidelity Life Association, A Legal Reserve Life Insurance Company	300774	Agent - Life	3/23/1999	1/6/2003

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	12/17/1996	6/19/2000
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	12/17/1996	6/19/2000
Inactive	Designated Agent Company Inc.	681257	Agent - Health	2/1/2014	5/31/2015