DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Management Inc.	DOIID	398236	NAIC NPN	7220752

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	10/4/1993	12/1/2000
Inactive	Resident	Agent	Life	10/4/1993	12/1/2000
* 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 Heritage Life Insurance Company	300272	Agent - Health	5/12/1995	4/17/2000
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	5/12/1995	4/17/2000
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Health	10/4/1993	4/22/2002
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Life	10/4/1993	4/22/2002

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Crouch, John Wendell	368171	Agent - Health	10/4/1993	4/5/1996
Inactive	Crouch, John Wendell	368171	Agent - Life	10/4/1993	4/5/1996
Inactive	Stilz, J Clifton	393429	Agent - Health	10/4/1993	12/1/2000
Inactive	Stilz, J Clifton	393429	Agent - Life	10/4/1993	12/1/2000