DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	EBC Company	DOIID	398393	NAIC NPN	7220861

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	12/20/1984	3/31/2012
Inactive	Resident	Agent	Health	12/20/1984	3/31/2012
* 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	Canada Life Assurance Company	301192	Agent - Health	12/4/1999	12/15/2004
Inactive	Canada Life Assurance Company	301192	Agent - Life	12/4/1999	12/15/2004
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	7/26/1999	3/31/2012
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	7/26/1999	3/31/2012
Inactive	Lafayette Life Insurance Company (The)	301039	Agent - Health	11/6/1995	3/12/2001
Inactive	Lafayette Life Insurance Company (The)	301039	Agent - Life	11/6/1995	3/12/2001
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	4/26/1996	3/31/2012
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	4/26/1996	3/31/2012
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	12/20/1984	3/31/1997
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	12/20/1984	3/31/1997
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	9/22/1994	4/6/2005
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	9/22/1994	4/6/2005
Inactive	Sun Life Assurance Company of Canada	301811	Agent - Life	5/24/2006	3/31/2012
Inactive	Wilco Life Insurance Company	300122	Agent - Health	6/20/1988	3/31/1997
Inactive	Wilco Life Insurance Company	300122	Agent - Life	6/20/1988	3/31/1997

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Kissling, Fred Ralph	392100	Agent - Health	12/20/1984	3/31/2012
Inactive	Kissling, Fred Ralph	392100	Agent - Life	12/20/1984	3/31/2012