DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Whitehead, Marlice Dawn	DOIID	503403	NAIC NPN	7211350

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Administrator	Not Applicable	4/18/2001	9/30/2003
Inactive	Resident	Agent	Life	10/24/2002	11/6/2002
Inactive	Resident	Agent	Health	10/24/2002	11/6/2002
* 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 Heritage Life Insurance Company	300272	Agent - Health	2/20/2002	7/1/2002
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	2/20/2002	7/1/2002
Inactive	American United Life Insurance Company	300498	Agent - Health	3/13/2000	7/1/2002
Inactive	American United Life Insurance Company	300498	Agent - Life	3/13/2000	7/1/2002
Inactive	Baltimore Life Insurance Company	300286	Agent - Health	3/19/2002	7/1/2002
Inactive	Baltimore Life Insurance Company	300286	Agent - Life	3/19/2002	7/1/2002
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	4/19/2002	7/1/2002
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	4/19/2002	7/1/2002
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	4/19/2002	7/1/2002
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	4/19/2002	7/1/2002
Inactive	Medical Life Insurance Company	300693	Agent - Health	5/13/2002	12/31/2004
Inactive	Medical Life Insurance Company	300693	Agent - Life	5/13/2002	12/31/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Kentucky Hospital Service Company of Kentucky, LLC	401254	Agent - Life	8/27/2001	7/1/2002
Inactive	Kentucky Hospital Service Company of Kentucky, LLC	401254	Agent - Health	8/27/2001	7/1/2002
Inactive	Kentucky Hospital Service Company of Kentucky, LLC	401254	Administrator - Not Applicable	4/18/2001	9/30/2003