DEPARTMENT OF INSURANCE
Affiliations
NameBallard II, Gaylord BernardDOIID393629NAIC NPN3206801
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveResidentAgentHealth9/8/199911/16/2005 
InactiveResidentAgentLife9/8/199911/16/2005 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveCombined Insurance Company of America301472Agent - Health9/8/19994/29/2005
InactiveCombined Insurance Company of America301472Agent - Life9/8/19994/29/2005
InactiveNassau Life Insurance Company of Kansas300667Agent - Health6/29/20059/22/2005
InactiveNassau Life Insurance Company of Kansas300667Agent - Life6/29/20059/22/2005
InactivePenn Treaty Network America Insurance Company301297Agent - Health5/9/200511/16/2005
InactivePenn Treaty Network America Insurance Company301297Agent - Life5/9/200511/16/2005
InactivePennsylvania Life Insurance Company301321Agent - Health7/10/200511/16/2005
InactivePennsylvania Life Insurance Company301321Agent - Life7/10/200511/16/2005
InactiveSenior Health Insurance Company of Pennsylvania300251Agent - Health2/14/20007/18/2003
InactiveSenior Health Insurance Company of Pennsylvania300251Agent - Life2/14/20007/18/2003
InactiveTime Insurance Company300683Agent - Health3/20/200210/25/2004
InactiveTime Insurance Company300683Agent - Life3/20/200210/25/2004
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveDiversified Insurance Marketing, Inc.502254Agent - Life5/11/200511/16/2005
InactiveDiversified Insurance Marketing, Inc.502254Agent - Health5/11/200511/16/2005

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