DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Family Health & Retirement Services Inc.	DOIID	399792	NAIC NPN	7221936

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	1/13/1994	5/31/2004
Inactive	Resident	Agent	Health	1/13/1994	5/31/2004
* 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	Pioneer Life Insurance Company	300110	Agent - Health	1/13/1994	7/1/2003
Inactive	Pioneer Life Insurance Company	300110	Agent - Life	1/13/1994	7/1/2003
Inactive	Washington National Insurance Company	300587	Agent - Health	7/1/2003	5/31/2004
Inactive	Washington National Insurance Company	300587	Agent - Life	7/1/2003	5/31/2004

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Given, Carole Joan	382358	Agent - Health	8/26/1987	1/5/1996
Inactive	Given, Carole Joan	382358	Agent - Life	8/26/1987	1/5/1996
Inactive	Given, Michael Terry	377902	Agent - Health	8/26/1987	5/31/2004
Inactive	Given, Michael Terry	377902	Agent - Life	8/26/1987	5/31/2004