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DEPARTMENT OF INSURANCE
Affiliations
Name
Ballard II, Gaylord Bernard
DOIID
393629
NAIC NPN
3206801
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Inactive
Resident
Agent
Health
9/8/1999
11/16/2005
Inactive
Resident
Agent
Life
9/8/1999
11/16/2005
* 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
Combined Insurance Company of America
301472
Agent - Health
9/8/1999
4/29/2005
Inactive
Combined Insurance Company of America
301472
Agent - Life
9/8/1999
4/29/2005
Inactive
Nassau Life Insurance Company of Kansas
300667
Agent - Health
6/29/2005
9/22/2005
Inactive
Nassau Life Insurance Company of Kansas
300667
Agent - Life
6/29/2005
9/22/2005
Inactive
Penn Treaty Network America Insurance Company
301297
Agent - Health
5/9/2005
11/16/2005
Inactive
Penn Treaty Network America Insurance Company
301297
Agent - Life
5/9/2005
11/16/2005
Inactive
Pennsylvania Life Insurance Company
301321
Agent - Health
7/10/2005
11/16/2005
Inactive
Pennsylvania Life Insurance Company
301321
Agent - Life
7/10/2005
11/16/2005
Inactive
Senior Health Insurance Company of Pennsylvania
300251
Agent - Health
2/14/2000
7/18/2003
Inactive
Senior Health Insurance Company of Pennsylvania
300251
Agent - Life
2/14/2000
7/18/2003
Inactive
Time Insurance Company
300683
Agent - Health
3/20/2002
10/25/2004
Inactive
Time Insurance Company
300683
Agent - Life
3/20/2002
10/25/2004
Designated to act on behalf of the following Business Entities
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Diversified Insurance Marketing, Inc.
502254
Agent - Life
5/11/2005
11/16/2005
Inactive
Diversified Insurance Marketing, Inc.
502254
Agent - Health
5/11/2005
11/16/2005
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