DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Don Beverly & Associates Inc.	DOIID	401078	NAIC NPN	2110481

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	4/11/1994	5/31/2004
Inactive	Resident	Agent	Life	4/11/1994	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	Centennial Life Insurance Company (The)	301561	Agent - Health	12/1/1995	3/31/1997
Inactive	Centennial Life Insurance Company (The)	301561	Agent - Life	12/1/1995	3/31/1997
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	Jefferson Pilot Financial Insurance Company	300756	Agent - Health	5/16/1994	3/31/1997
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	5/16/1994	3/31/1997
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	6/17/1997	5/31/2004
Inactive	Pioneer Life Insurance Company	300110	Agent - Health	10/7/1994	8/20/2003
Inactive	Pioneer Life Insurance Company	300110	Agent - Life	10/7/1994	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
Inactive	Southwestern Life Insurance Company	301343	Agent - Health	12/4/1997	5/2/2003
Inactive	Southwestern Life Insurance Company	301343	Agent - Life	12/4/1997	5/2/2003
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	4/11/1994	4/25/1997
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Life	4/11/1994	4/25/1997
Inactive	Time Insurance Company	300683	Agent - Health	9/8/1997	5/22/2000
Inactive	Time Insurance Company	300683	Agent - Life	9/8/1997	5/22/2000
Inactive	Union Security Insurance Company	301844	Agent - Health	11/3/1999	11/25/2002

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Beverly, Donald Eugene	358870	Agent - Health	4/11/1994	5/31/2004
Inactive	Beverly, Donald Eugene	358870	Agent - Life	4/11/1994	5/31/2004
Inactive	Beverly, Edith Loraine	333047	Agent - Health	4/11/1994	3/6/2003
Inactive	Beverly, Edith Loraine	333047	Agent - Life	4/11/1994	3/6/2003