DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Southern Brokers Insurance Center Inc.	DOIID	399917	NAIC NPN	3007790

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	10/11/1988	5/31/2004
Inactive	Resident	Agent	Health	10/11/1988	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	Conseco Health Insurance Company	301725	Agent - Health	9/6/2000	5/31/2004
Inactive	Conseco Health Insurance Company	301725	Agent - Life	9/6/2000	5/31/2004
Inactive	Conseco Medical Insurance Company	300719	Agent - Health	3/21/1997	12/22/1998
Inactive	Life Insurance Company of North America	300711	Agent - Health	8/15/1989	12/21/1998
Inactive	Life Insurance Company of North America	300711	Agent - Life	8/15/1989	12/21/1998
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	10/11/1988	9/1/1998
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	10/11/1988	9/1/1998
Inactive	Pioneer Life Insurance Company	300110	Agent - Health	2/20/1997	8/20/2003
Inactive	Pioneer Life Insurance Company	300110	Agent - Life	2/20/1997	8/20/2003
Inactive	Senior Health Insurance Company of Pennsylvania	300251	Agent - Health	12/6/2000	11/19/2003
Inactive	Senior Health Insurance Company of Pennsylvania	300251	Agent - Life	12/6/2000	11/19/2003

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bennett, Jeannetta N	356341	Agent - Health	9/3/1991	5/31/2004
Inactive	Bennett, Jeannetta N	356341	Agent - Life	9/3/1991	5/31/2004