DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Collier II, John M	DOIID	393863	NAIC NPN	7210287

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Adjuster	Independent	3/6/1996	3/18/2000
Inactive	Resident	Agent	Life	7/2/1998	12/1/2000
Inactive	Resident	Agent	Health	7/2/1998	12/1/2000
Inactive	Resident	Apprentice Adjuster	Not Applicable	3/24/1995	3/6/1996
* 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	Nationwide Life Insurance Company	300495	Agent - Health	7/2/1998	12/1/2000
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	7/2/1998	12/1/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Nationwide Mutual Insurance Company	301749	Adjuster - Independent	3/6/1996	3/18/2000

Sponsored By

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Davis, Leonard David	390075	Apprentice Adjuster - Not Applicable	3/24/1995	3/6/1996