DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Diversified Insurance Marketing, Inc.	DOIID	502254	NAIC NPN	7223062

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	2/28/2000	3/2/2006
Inactive	Resident	Agent	Life	2/28/2000	3/2/2006
* 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	American National Insurance Company	301861	Agent - Health	9/23/2004	3/2/2006
Inactive	American National Insurance Company	301861	Agent - Life	9/23/2004	3/2/2006
Inactive	Conseco Health Insurance Company	301725	Agent - Health	4/25/2001	5/28/2004
Inactive	Conseco Health Insurance Company	301725	Agent - Life	4/25/2001	5/28/2004
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Health	7/27/2000	3/2/2006
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Life	7/27/2000	3/2/2006
Inactive	Penn Treaty Network America Insurance Company	301297	Agent - Health	1/12/2001	12/4/2002
Inactive	Penn Treaty Network America Insurance Company	301297	Agent - Life	1/12/2001	12/4/2002
Inactive	Senior Health Insurance Company of Pennsylvania	300251	Agent - Health	2/28/2000	7/18/2003
Inactive	Senior Health Insurance Company of Pennsylvania	300251	Agent - Life	2/28/2000	7/18/2003
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	9/23/2004	3/2/2006
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Life	9/23/2004	3/2/2006
Inactive	Time Insurance Company	300683	Agent - Health	3/20/2002	10/26/2004
Inactive	Time Insurance Company	300683	Agent - Life	3/20/2002	10/26/2004

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Ballard, Gaylord Bernard	393629	Agent - Health	5/11/2005	11/16/2005
Inactive	Ballard, Gaylord Bernard	393629	Agent - Life	5/11/2005	11/16/2005
Inactive	Fant, Milton Wendell	385029	Agent - Health	12/13/2005	3/2/2006
Inactive	Fant, Milton Wendell	385029	Agent - Life	12/13/2005	3/2/2006
Denied	Morse, Sabrina Arnold	343604	Agent - Health
Denied	Morse, Sabrina Arnold	343604	Agent - Life