DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Smith, Leslie E	DOIID	553879	NAIC NPN	126794

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	8/15/2002	10/31/2006
Inactive	Non Resident	Agent	Health	8/15/2002	10/31/2006
* 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
Inactive	American Fidelity Assurance Company	301004	Agent - Health	8/15/2002	11/30/2005
Inactive	American Fidelity Assurance Company	301004	Agent - Life	8/15/2002	11/30/2005
Inactive	National Guardian Life Insurance Company	300596	Agent - Health	12/13/2005	10/31/2006
Inactive	National Guardian Life Insurance Company	300596	Agent - Life	12/13/2005	10/31/2006

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	3/26/2003	11/30/2005