DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Theis, Terry John	DOIID	542487	NAIC NPN	1782680

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	12/10/2001	4/30/2005
Inactive	Non Resident	Agent	Life	12/10/2001	4/30/2005
* 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.	300694	Agent - Health	6/3/2002	4/12/2005
Inactive	Aetna Life Insurance Company	301140	Agent - Health	6/3/2002	4/12/2005
Inactive	Aetna Life Insurance Company	301140	Agent - Life	6/3/2002	4/12/2005
Inactive	Anthem Life Insurance Company	301209	Agent - Health	12/10/2001	4/30/2005
Inactive	Anthem Life Insurance Company	301209	Agent - Life	12/10/2001	4/30/2005
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	2/8/2002	4/30/2005
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	2/8/2002	4/30/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	1/2/2002	4/30/2005
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	1/2/2002	4/30/2005