DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Gardner, Ann Marie	DOIID	505752	NAIC NPN	690925

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	5/22/2000	8/31/2004
Inactive	Non Resident	Agent	Life	5/22/2000	8/31/2004
* 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	Northern Life Insurance Company	300301	Agent - Life	10/29/2001	10/2/2002
Inactive	ReliaStar Life Insurance Company	301712	Agent - Health	5/22/2000	8/31/2004
Inactive	ReliaStar Life Insurance Company	301712	Agent - Life	5/22/2000	8/31/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Investors Brokerage Services Insurance Agency Inc.	399040	Agent - Life	10/2/2001	2/24/2003