DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Dorley, Momolu S.	DOIID	559866	NAIC NPN	7439746

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	11/8/2002	10/6/2003
Inactive	Non Resident	Agent	Health	11/8/2002	10/6/2003
* 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	National Teachers Associates Life Insurance Company	300107	Agent - Health	11/8/2002	8/26/2003
Inactive	National Teachers Associates Life Insurance Company	300107	Agent - Life	11/8/2002	8/26/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	National Teacher Associates of Kentucky Inc.	399320	Agent - Health	12/9/2002	10/6/2003
Inactive	National Teacher Associates of Kentucky Inc.	399320	Agent - Life	12/9/2002	10/6/2003