DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Bross, Douglas Montrell	DOIID	522306	NAIC NPN	7216639

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Limited Line Credit	9/28/2007	9/30/2008
Inactive	Resident	Agent	Health	6/24/2005	7/1/2006
Inactive	Resident	Agent	Life	6/24/2005	7/1/2006
* 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
Denied	American Bankers Insurance Company of Florida	300360	Agent - Health
Inactive	American Bankers Life Assurance Company of Florida	300171	Agent - Health	6/30/2005	7/1/2006
Inactive	American Bankers Life Assurance Company of Florida	300171	Agent - Life	6/30/2005	7/1/2006
Inactive	American Bankers Life Assurance Company of Florida	300171	Agent - Limited Line Credit	10/2/2007	7/3/2008
Inactive	American Reliable Insurance Company	301889	Agent - Limited Line Credit	10/2/2007	7/3/2008
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Health	11/21/2003	7/1/2004
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	11/21/2003	7/1/2004
Inactive	Everlake Life Insurance Company	300873	Agent - Life	9/5/2003	7/1/2004
Inactive	Glenbrook Life and Annuity Company	301384	Agent - Life	9/5/2003	7/1/2004
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	12/6/2002	7/1/2004
Inactive	Life Investors Insurance Company of America	301793	Agent - Life	9/5/2003	7/1/2004
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	3/10/2003	7/11/2003
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	2/10/2003	7/1/2004
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	9/5/2003	7/1/2004
Inactive	Western National Life Insurance Company	300461	Agent - Life	12/4/2002	7/1/2004
Inactive	Western-Southern Life Assurance Company	301590	Agent - Health	2/20/2002	7/1/2004
Denied	Western-Southern Life Assurance Company	301590	Agent - Life

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Fifth Third Insurance Agency Inc	399341	Agent - Life	4/27/2004	7/1/2004