DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Independent Brokerage Network	DOIID	505478	NAIC NPN	963079

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	4/21/2000	3/31/2010
Inactive	Non Resident	Agent	Health	4/21/2000	3/31/2010
* 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	Chase Insurance Life and Annuity Company	300518	Agent - Health	4/21/2000	4/1/2007
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	4/21/2000	4/1/2007
Inactive	Continental General Insurance Company	300691	Agent - Health	8/28/2006	11/28/2008
Inactive	Continental General Insurance Company	300691	Agent - Life	8/28/2006	11/28/2008
Inactive	EMC National Life Company	300388	Agent - Life	7/18/2003	5/9/2005
Inactive	Fidelity Life Association, A Legal Reserve Life Insurance Company	300774	Agent - Life	3/16/2006	3/31/2010
Inactive	National Travelers Life Company	300304	Agent - Life	3/25/2003	6/30/2003
Inactive	Protective Life Insurance Company	300638	Agent - Health	4/1/2007	3/31/2010
Inactive	Protective Life Insurance Company	300638	Agent - Life	4/1/2007	3/31/2010
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Life	12/3/2003	10/23/2007
Inactive	West Coast Life Insurance Company	301607	Agent - Life	7/31/2006	3/31/2009

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Freking, Lawrence J	306738	Agent - Life	4/21/2000	3/31/2010
Inactive	Yaden, Donnie Gene	308784	Agent - Health	4/21/2000	3/31/2010