DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Smith, Douglas Wayne	DOIID	524207	NAIC NPN	1979209

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	4/2/2001	8/31/2016
Inactive	Non Resident	Agent	Health	4/2/2001	8/31/2016
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	2/19/2008	8/31/2016
Inactive	Aetna Life Insurance Company	301140	Agent - Health	2/19/2008	8/31/2016
Inactive	Aetna Life Insurance Company	301140	Agent - Life	2/19/2008	8/31/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Health	8/1/2006	8/31/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	8/1/2006	8/31/2016
Inactive	Peoples Benefit Life Insurance Company	301895	Agent - Health	4/2/2001	10/1/2007
Inactive	Peoples Benefit Life Insurance Company	301895	Agent - Life	4/2/2001	10/1/2007
Inactive	Time Insurance Company	300683	Agent - Health	8/30/2012	1/17/2014
Inactive	Time Insurance Company	300683	Agent - Life	8/30/2012	1/17/2014
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	9/18/2007	8/31/2016
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	9/18/2007	8/31/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bollinger Inc.	401156	Agent - Health	3/10/2003	10/5/2016
Inactive	Bollinger Inc.	401156	Agent - Life	3/10/2003	10/5/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/2/2013	8/31/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/2/2013	8/31/2016