DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Douglas, Adam Christopher	DOIID	556165	NAIC NPN	7372357

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	9/18/2002	12/6/2004
Inactive	Non Resident	Agent	Health	9/18/2002	12/6/2004
* 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	First Colony Life Insurance Company	301179	Agent - Health	9/18/2002	8/4/2003
Inactive	First Colony Life Insurance Company	301179	Agent - Life	9/18/2002	8/4/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	SelectQuote Insurance Services	533194	Agent - Health	10/17/2002	1/23/2004
Inactive	SelectQuote Insurance Services	533194	Agent - Life	10/17/2002	8/4/2003