DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	First Service Corporation	DOIID	400966	NAIC NPN	7222800

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	7/2/1992	12/1/2000
Inactive	Resident	Agent	Life	7/2/1992	12/1/2000
* 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

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Alexander Hamilton Life Insurance Co. of America	301779	Agent - Health	7/2/1992	8/1/2000
Inactive	Alexander Hamilton Life Insurance Co. of America	301779	Agent - Life	7/2/1992	8/1/2000
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Health	8/1/2000	4/22/2002
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	8/1/2000	4/22/2002

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Wells, Wayne Lincoln	306089	Agent - Health	8/27/1986	12/1/2000
Inactive	Wells, Wayne Lincoln	306089	Agent - Life	8/27/1986	12/1/2000