DEPARTMENT OF INSURANCE
Affiliations
NameCapital Concepts Inc.DOIID399290NAIC NPN7221562
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveResidentAgentHealth6/26/19985/31/2004 
InactiveResidentAgentCasualty8/15/20001/14/2004 
InactiveResidentAgentLife6/26/19985/31/2004 
InactiveResidentAgentProperty8/15/20001/14/2004 
InactiveResidentAgentGeneral Lines6/9/19998/15/2000 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
Inactive21st Century North America Insurance Company300884Agent - Casualty8/15/20001/14/2004
Inactive21st Century North America Insurance Company300884Agent - General Lines6/9/19998/15/2000
Inactive21st Century North America Insurance Company300884Agent - Property8/15/20001/14/2004
InactiveAllianz Life Insurance Company of North America301791Agent - Health9/9/19985/31/2004
InactiveAllianz Life Insurance Company of North America301791Agent - Life9/9/19985/31/2004
InactiveAllied Life Insurance Company301294Agent - Health6/26/19981/1/2000
InactiveAllied Life Insurance Company301294Agent - Life6/26/19981/1/2000
InactiveGenworth Life Insurance Company300623Agent - Health2/28/20005/31/2004
InactiveGenworth Life Insurance Company300623Agent - Life2/28/20005/31/2004
InactiveMetropolitan Life Insurance Company301948Agent - Health10/14/19985/31/2004
InactiveMetropolitan Life Insurance Company301948Agent - Life10/14/19985/31/2004
InactiveReassure America Life Insurance Company300678Agent - Health1/1/20005/31/2004
InactiveReassure America Life Insurance Company300678Agent - Life1/1/20005/31/2004
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveBunch, Ellen J 342483Agent - Health6/26/19985/31/2004
InactiveBunch, Ellen J 342483Agent - Life6/26/19985/31/2004
InactiveBunning, Donna M 369959Agent - Health6/26/19985/31/2004
InactiveBunning, Donna M 369959Agent - Life6/26/19985/31/2004
InactiveDental Choice Agency Inc.398085Agent - Health3/1/200112/31/2001
InactiveDental Choice Agency Inc.398085Agent - Prepaid Dental Plan8/9/19993/1/2001
InactiveHorn, William Ray 355189Agent - Casualty8/15/20001/14/2004
InactiveHorn, William Ray 355189Agent - General Lines6/9/19998/15/2000
InactiveHorn, William Ray 355189Agent - Property8/15/20001/14/2004
InactiveShepard, Mitchell Deems 361740Agent - Health6/10/20035/31/2004
InactiveShepard, Mitchell Deems 361740Agent - Life6/10/20035/31/2004

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