DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Osborne, Connie Ervin	DOIID	534550	NAIC NPN	7218632

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	4/17/2003	3/1/2015
Inactive	Resident	Agent	Health	4/17/2003	3/1/2015
* 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	Colonial Life and Accident Insurance Company	300846	Agent - Health	5/5/2003	3/5/2013
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	5/5/2003	3/5/2013
Inactive	Primerica Life Insurance Company	300970	Agent - Health	10/9/2001	12/16/2002
Inactive	Primerica Life Insurance Company	300970	Agent - Life	10/9/2001	12/16/2002
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	7/29/2004	3/1/2015
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	7/29/2004	3/1/2015
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	7/17/2006	11/10/2010
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	7/17/2006	11/10/2010
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Health	7/19/2006	10/1/2008
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Life	7/19/2006	10/1/2008
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	7/29/2004	3/1/2015
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	7/29/2004	3/1/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	10/31/2007	1/14/2014