DEPARTMENT OF INSURANCE
Affiliations
NameMutual Service CorporationDOIID400249NAIC NPN100301
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveResidentAgentVariable Life and Variable Annuities7/27/20013/31/2011 
InactiveResidentAgentHealth11/6/19993/31/2011 
InactiveResidentAgentLife7/30/20013/31/2011 
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAllianz Life Insurance Company of North America301791Agent - Life7/30/20013/31/2011
InactiveAllianz Life Insurance Company of North America301791Agent - Variable Life and Variable Annuities7/27/20013/31/2011
InactiveAmerican General Life Insurance Company of Delaware301057Agent - Life7/30/20019/20/2005
InactiveAmerican General Life Insurance Company of Delaware301057Agent - Variable Life and Variable Annuities7/27/20019/20/2005
InactiveAmeritas Life Insurance Corporation300126Agent - Life4/9/20079/17/2009
InactiveAmeritas Life Insurance Corporation300126Agent - Variable Life and Variable Annuities4/9/20079/17/2009
InactiveAmeritas Variable Life Insurance Company300665Agent - Life7/30/20015/1/2007
InactiveAugustar Life Insurance Company301816Agent - Life8/24/20012/8/2011
InactiveAugustar Life Insurance Company301816Agent - Variable Life and Variable Annuities8/24/20013/31/2011
InactiveC.M. Life Insurance Company301335Agent - Health4/9/20018/19/2010
InactiveC.M. Life Insurance Company301335Agent - Life7/30/20018/19/2010
InactiveC.M. Life Insurance Company301335Agent - Variable Life and Variable Annuities7/27/20018/19/2010
InactiveChase Insurance Life and Annuity Company300518Agent - Life9/23/20034/1/2007
InactiveColumbus Life Insurance Company301227Agent - Life11/19/20013/31/2011
InactiveColumbus Life Insurance Company301227Agent - Variable Life and Variable Annuities11/19/20013/31/2011
InactiveCommonwealth Annuity and Life Insurance Company300798Agent - Life7/30/200112/31/2008
InactiveConnecticut General Life Insurance Company301333Agent - Life7/30/20013/31/2011
InactiveContinental Casualty Company301019Agent - Health12/13/199911/29/2004
InactiveDelaware Life Insurance Company301256Agent - Life7/30/200110/9/2009
InactiveDelaware Life Insurance Company301256Agent - Variable Life and Variable Annuities7/27/200110/9/2009
InactiveEmpower Annuity Insurance Company300168Agent - Health5/29/20073/31/2011
InactiveEmpower Annuity Insurance Company300168Agent - Life5/29/20073/31/2011
InactiveEmpower Annuity Insurance Company300168Agent - Variable Life and Variable Annuities5/29/20073/31/2011
InactiveEquitable Financial Life Insurance Company300808Agent - Life7/30/200111/10/2009
InactiveEquitable Financial Life Insurance Company300808Agent - Variable Life and Variable Annuities7/27/200111/10/2009
InactiveEquitable Financial Life Insurance Company of America301772Agent - Life9/9/20023/31/2011
InactiveEquitable Financial Life Insurance Company of America301772Agent - Variable Life and Variable Annuities9/9/20023/31/2011
InactiveEquitable Financial Life and Annuity Company301833Agent - Life5/18/19992/3/2003
InactiveEquitable Life Insurance Company of Iowa301633Agent - Variable Life and Variable Annuities3/31/20011/1/2004
InactiveEverlake Life Insurance Company300873Agent - Life11/25/20038/26/2010
InactiveEverlake Life Insurance Company300873Agent - Variable Life and Variable Annuities11/25/20038/26/2010
InactiveFirst Colony Life Insurance Company301179Agent - Health7/23/20011/1/2007
InactiveFirst Colony Life Insurance Company301179Agent - Life7/30/20011/1/2007
InactiveFortitude Life Insurance & Annuity Company301503Agent - Life7/30/20013/31/2011
InactiveFortitude Life Insurance & Annuity Company301503Agent - Variable Life and Variable Annuities7/27/20013/31/2011
InactiveGenworth Life Insurance Company300623Agent - Health8/21/20043/31/2011
InactiveGenworth Life Insurance Company300623Agent - Life8/21/20043/31/2011
InactiveGenworth Life and Annuity Insurance Company301276Agent - Health1/2/20023/31/2011
InactiveGenworth Life and Annuity Insurance Company301276Agent - Life1/2/20023/31/2011
InactiveGenworth Life and Annuity Insurance Company301276Agent - Variable Life and Variable Annuities1/2/20023/31/2011
InactiveGlenbrook Life and Annuity Company301384Agent - Life11/25/20031/1/2005
InactiveGlenbrook Life and Annuity Company301384Agent - Variable Life and Variable Annuities11/25/20031/1/2005
InactiveGuardian Insurance & Annuity Company Inc. (The)301920Agent - Life7/30/20019/14/2009
InactiveGuardian Insurance & Annuity Company Inc. (The)301920Agent - Variable Life and Variable Annuities7/27/20019/14/2009
InactiveJackson National Life Insurance Company300486Agent - Life7/30/20019/8/2009
InactiveJackson National Life Insurance Company300486Agent - Variable Life and Variable Annuities7/27/20019/8/2009
InactiveJefferson National Life Insurance Company300258Agent - Life7/30/20016/8/2006
InactiveJefferson Pilot Financial Insurance Company300756Agent - Health5/7/20017/2/2007
InactiveJefferson Pilot Financial Insurance Company300756Agent - Life7/30/20017/2/2007
InactiveJefferson Pilot Financial Insurance Company300756Agent - Variable Life and Variable Annuities7/27/20017/2/2007
InactiveJohn Hancock Life Insurance Company300821Agent - Health10/10/200012/30/2009
InactiveJohn Hancock Life Insurance Company300821Agent - Life7/30/200112/30/2009
InactiveJohn Hancock Life Insurance Company300821Agent - Variable Life and Variable Annuities10/18/200112/30/2009
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Health12/30/20093/31/2011
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Life7/30/20013/31/2011
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Variable Life and Variable Annuities12/30/20093/31/2011
InactiveJohn Hancock Variable Life Insurance Company301914Agent - Health9/25/20002/24/2009
InactiveJohn Hancock Variable Life Insurance Company301914Agent - Life7/30/20012/24/2009
InactiveJohn Hancock Variable Life Insurance Company301914Agent - Variable Life and Variable Annuities10/18/20012/24/2009
InactiveKeyport Life Insurance Company300319Agent - Life9/18/199112/31/2003
InactiveKeyport Life Insurance Company300319Agent - Variable Life and Variable Annuities4/24/200112/31/2003
InactiveLincoln Benefit Life Company301110Agent - Health11/22/200611/16/2009
InactiveLincoln Benefit Life Company301110Agent - Life11/22/200611/16/2009
InactiveLincoln Benefit Life Company301110Agent - Variable Life and Variable Annuities11/22/200611/16/2009
InactiveLincoln National Life Insurance Company (The)301382Agent - Health8/28/20009/22/2009
InactiveLincoln National Life Insurance Company (The)301382Agent - Life7/30/20019/22/2009
InactiveLincoln National Life Insurance Company (The)301382Agent - Variable Life and Variable Annuities7/27/20019/22/2009
InactiveMML Bay State Life Insurance Company301198Agent - Health4/9/20018/19/2010
InactiveMML Bay State Life Insurance Company301198Agent - Life7/30/20018/19/2010
InactiveMML Bay State Life Insurance Company301198Agent - Variable Life and Variable Annuities7/27/20018/19/2010
InactiveMONY Life Insurance Company301141Agent - Life9/9/20028/26/2003
InactiveMONY Life Insurance Company301141Agent - Variable Life and Variable Annuities9/9/20028/26/2003
InactiveManufacturers Life Insurance Company300855Agent - Life10/5/199412/31/1996
InactiveManufacturers Life Insurance Company of America (The)300618Agent - Life11/4/199412/31/2001
InactiveManufacturers Life Insurance Company of America (The)300618Agent - Variable Life and Variable Annuities7/27/200112/31/2001
InactiveManufacturers Life Insurance Company of North America301899Agent - Life10/26/19871/22/2002
InactiveMassachusetts Mutual Life Insurance Company300445Agent - Health4/9/20018/19/2010
InactiveMassachusetts Mutual Life Insurance Company300445Agent - Life7/30/20018/19/2010
InactiveMassachusetts Mutual Life Insurance Company300445Agent - Variable Life and Variable Annuities7/27/20018/19/2010
InactiveMetLife Investors Insurance Company301872Agent - Health2/18/20059/30/2009
InactiveMetLife Investors Insurance Company301872Agent - Life2/18/20059/30/2009
InactiveMetLife Investors Insurance Company301872Agent - Variable Life and Variable Annuities2/18/20059/30/2009
InactiveMetLife Investors USA Insurance Company300845Agent - Health1/30/20049/30/2009
InactiveMetLife Investors USA Insurance Company300845Agent - Life1/30/20049/30/2009
InactiveMetLife Investors USA Insurance Company300845Agent - Variable Life and Variable Annuities1/30/20049/30/2009
InactiveMetropolitan Life Insurance Company301948Agent - Life7/30/20013/31/2011
InactiveMidland National Life Insurance Company300923Agent - Health8/7/200010/20/2009
InactiveMidland National Life Insurance Company300923Agent - Life7/30/200110/20/2009
InactiveMidland National Life Insurance Company300923Agent - Variable Life and Variable Annuities2/17/200510/20/2009
InactiveNassau Life Insurance Company301406Agent - Life7/30/20019/18/2010
InactiveNassau Life Insurance Company301406Agent - Variable Life and Variable Annuities7/27/20019/18/2010
InactiveNational Life Insurance Company301852Agent - Health5/21/200112/12/2008
InactiveNational Life Insurance Company301852Agent - Life7/30/200112/12/2008
InactiveNational Life Insurance Company301852Agent - Variable Life and Variable Annuities7/27/200112/12/2008
InactiveNationwide Life Insurance Company300495Agent - Life7/30/20019/13/2010
InactiveNationwide Life Insurance Company300495Agent - Variable Life and Variable Annuities7/27/20019/13/2010
InactiveNationwide Life Insurance Company of America301134Agent - Life7/30/200112/31/2009
InactiveNationwide Life Insurance Company of America301134Agent - Variable Life and Variable Annuities7/27/200112/31/2009
InactiveNationwide Life and Annuity Insurance Company300714Agent - Life7/30/20019/13/2010
InactiveNew York Life Insurance and Annuity Corporation300726Agent - Life7/30/20013/31/2011
InactivePHL Variable Insurance Company300525Agent - Life7/30/20019/18/2010
InactivePHL Variable Insurance Company300525Agent - Variable Life and Variable Annuities7/27/20019/18/2010
InactivePacific Life Insurance Company301848Agent - Health11/6/19995/6/2010
InactivePacific Life Insurance Company301848Agent - Life7/30/20015/6/2010
InactivePacific Life Insurance Company301848Agent - Variable Life and Variable Annuities7/27/20015/6/2010
InactivePenn Insurance and Annuity Company300712Agent - Life7/30/20013/31/2011
InactivePenn Insurance and Annuity Company300712Agent - Variable Life and Variable Annuities4/17/20093/31/2011
InactivePenn Mutual Life Insurance Company301394Agent - Life7/30/20013/31/2011
InactivePenn Mutual Life Insurance Company301394Agent - Variable Life and Variable Annuities4/17/20093/31/2011
InactivePrincipal Life Insurance Company300129Agent - Life7/30/20019/14/2009
InactivePrincipal Life Insurance Company300129Agent - Variable Life and Variable Annuities7/27/20019/14/2009
InactiveProtective Life Insurance Company300638Agent - Life4/1/20073/31/2011
InactiveProtective Life Insurance Company300638Agent - Variable Life and Variable Annuities12/11/20013/31/2011
InactivePruco Life Insurance Company300954Agent - Life7/30/20013/31/2011
InactivePruco Life Insurance Company300954Agent - Variable Life and Variable Annuities7/27/20013/31/2011
InactivePrudential Insurance Company of America300784Agent - Life7/30/20013/31/2011
InactivePrudential Insurance Company of America300784Agent - Variable Life and Variable Annuities7/27/20013/31/2011
InactiveReassure America Life Insurance Company301902Agent - Health11/22/20009/20/2004
InactiveReassure America Life Insurance Company301902Agent - Life7/30/20019/20/2004
InactiveSecurity Life of Denver Insurance Company300648Agent - Life7/30/200110/20/2009
DeniedSecurity Life of Denver Insurance Company300648Agent - Variable Life and Variable Annuities  
InactiveStandard Insurance Company300185Agent - Health12/5/20033/31/2011
InactiveStandard Insurance Company300185Agent - Life12/5/20033/31/2011
InactiveSunAmerica Annuity and Life Assurance Company301930Agent - Life7/30/20013/31/2011
InactiveSunAmerica Annuity and Life Assurance Company301930Agent - Variable Life and Variable Annuities6/24/20083/31/2011
InactiveSunAmerica Life Insurance Company300096Agent - Life1/26/19933/31/2003
InactiveTalcott Resolution Life Insurance Company301759Agent - Life7/30/20011/21/2010
InactiveTalcott Resolution Life Insurance Company301759Agent - Variable Life and Variable Annuities11/13/20011/21/2010
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Life7/30/20011/21/2010
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Variable Life and Variable Annuities11/13/20011/21/2010
InactiveTransamerica Life Insurance Company300571Agent - Health10/1/200810/23/2009
InactiveTransamerica Life Insurance Company300571Agent - Life9/17/200510/23/2009
InactiveTransamerica Life Insurance Company300571Agent - Variable Life and Variable Annuities10/1/200510/23/2009
InactiveTransamerica Life Insurance and Annuity Company300148Agent - Life7/30/200110/1/2005
InactiveTransamerica Life Insurance and Annuity Company300148Agent - Variable Life and Variable Annuities9/25/200310/1/2005
InactiveTransamerica Occidental Life Insurance Company300966Agent - Health4/30/200110/1/2008
InactiveTransamerica Occidental Life Insurance Company300966Agent - Life7/30/200110/1/2008
InactiveTransamerica Occidental Life Insurance Company300966Agent - Variable Life and Variable Annuities9/25/200310/1/2008
InactiveUSG Annuity & Life Company300457Agent - Life8/13/20011/1/2004
InactiveVenerable Insurance and Annuity Company301006Agent - Life1/1/20043/31/2011
InactiveVenerable Insurance and Annuity Company301006Agent - Variable Life and Variable Annuities7/27/20013/31/2011
InactiveVoya Retirement Insurance and Annuity Company300643Agent - Health3/13/20003/31/2011
InactiveVoya Retirement Insurance and Annuity Company300643Agent - Life7/30/20013/31/2011
InactiveVoya Retirement Insurance and Annuity Company300643Agent - Variable Life and Variable Annuities7/27/20013/31/2011
InactiveWestern National Life Insurance Company300461Agent - Life7/30/20013/23/2009
InactiveWestern National Life Insurance Company300461Agent - Variable Life and Variable Annuities7/27/20013/31/2011
InactiveWestern Reserve Life Assurance Company of Ohio300760Agent - Life7/30/200112/5/2008
InactiveWestern Reserve Life Assurance Company of Ohio300760Agent - Variable Life and Variable Annuities7/27/200112/5/2008
InactiveZurich American Life Insurance Company300216Agent - Life7/30/20013/31/2011
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveBecker, Mary M 361575Agent - Life9/1/198711/27/1999
InactiveDixon, John Lincoln 322595Agent - Health11/6/19995/8/2006
InactiveDixon, John Lincoln 322595Agent - Life3/31/19935/8/2006
InactiveDixon, John Lincoln 322595Agent - Variable Life and Variable Annuities3/1/20015/8/2006
DeniedKopf, Arthur Thomas 700293Agent - Health  
InactiveKopf, Arthur Thomas 700293Agent - Life3/13/20095/12/2010
InactiveKopf, Arthur Thomas 700293Agent - Variable Life and Variable Annuities3/13/20095/12/2010
InactiveLyle, Timothy James 323044Agent - Health2/9/20073/2/2009
InactiveLyle, Timothy James 323044Agent - Life2/9/20073/2/2009
InactiveLyle, Timothy James 323044Agent - Variable Life and Variable Annuities2/9/20073/2/2009
InactivePolley, Diane Renee 306010Agent - Health2/9/20073/31/2011
InactivePolley, Diane Renee 306010Agent - Life2/9/20073/31/2011
InactivePolley, Diane Renee 306010Agent - Variable Life and Variable Annuities2/9/20073/31/2011
DeniedRyan, Sheri Lynn 678883Agent - Life  

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