DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Crown Life Agency West Incorporated	DOIID	400984	NAIC NPN	7222812

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	4/12/1990	3/31/1999
Inactive	Resident	Agent	Life	4/12/1990	3/31/1999
* 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	Crown Life Insurance Company	300151	Agent - Health	4/12/1990	3/31/1999
Inactive	Crown Life Insurance Company	300151	Agent - Life	4/12/1990	3/31/1999

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Clark, Barry Kenneth	371255	Agent - Health	4/12/1990	3/31/1999