DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Blank, Diane Barbara	DOIID	524799	NAIC NPN	104681

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	4/13/2001	12/31/2010
Inactive	Non Resident	Agent	Health	4/13/2001	12/31/2010
* 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	Everlake Life Insurance Company	300873	Agent - Health	4/13/2001	6/28/2004
Inactive	Everlake Life Insurance Company	300873	Agent - Life	4/13/2001	6/28/2004
Inactive	Gerber Life Insurance Company	300529	Agent - Health	8/21/2008	1/7/2009
Inactive	Gerber Life Insurance Company	300529	Agent - Life	8/21/2008	1/7/2009
Inactive	Globe Life and Accident Insurance Company	300639	Agent - Health	9/26/2005	12/17/2007
Inactive	Globe Life and Accident Insurance Company	300639	Agent - Life	9/26/2005	12/17/2007
Inactive	Minnesota Life Insurance Company	300488	Agent - Health	7/28/2004	4/16/2009
Inactive	Minnesota Life Insurance Company	300488	Agent - Life	7/28/2004	4/16/2009
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	8/19/2004	11/13/2006
Inactive	Sears Life Insurance Company	300218	Agent - Health	12/6/2004	7/28/2008
Inactive	Sears Life Insurance Company	300218	Agent - Life	12/6/2004	7/28/2008
Inactive	Stonebridge Life Insurance Company	301614	Agent - Health	12/21/2004	4/14/2009
Inactive	Stonebridge Life Insurance Company	301614	Agent - Life	12/21/2004	4/14/2009
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	11/14/2005	4/14/2009
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	11/14/2005	4/14/2009
Inactive	Trustmark Insurance Company	300317	Agent - Health	2/6/2003	12/31/2010
Inactive	Trustmark Insurance Company	300317	Agent - Life	2/6/2003	12/31/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Americall Corporation	520281	Agent - Health	2/9/2005	1/8/2010
Inactive	Americall Corporation	520281	Agent - Life	2/9/2005	1/8/2010