DEPARTMENT OF INSURANCE

Affiliations

Name	National Association of Insurance Marketers	DOIID	562465	NAIC NPN	4567340

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	1/21/2003	3/31/2025
Active	Non Resident	Agent	Life	1/21/2003	3/31/2025
* 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 General Life Insurance Company	301585	Agent - Health	5/2/2013	9/8/2015
Inactive	American General Life Insurance Company	301585	Agent - Life	5/2/2013	9/8/2015
Inactive	American Pioneer Life Insurance Company	301782	Agent - Health	7/10/2004	2/10/2015
Inactive	American Pioneer Life Insurance Company	301782	Agent - Life	7/10/2004	2/10/2015
Active	Assurity Life Insurance Company	301099	Agent - Health	1/27/2009
Active	Assurity Life Insurance Company	301099	Agent - Life	1/27/2009
Inactive	Athene Annuity and Life Company	301893	Agent - Life	9/19/2008	7/10/2014
Active	Banner Life Insurance Company	301696	Agent - Life	2/2/2010
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Health	3/11/2008	1/31/2011
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Life	3/11/2008	1/31/2011
Inactive	Indianapolis Life Insurance Company	301381	Agent - Life	7/28/2005	10/1/2008
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	5/16/2011	8/31/2020
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	5/16/2011	8/31/2020
Active	Madison National Life Insurance Company Inc.	301458	Agent - Health	8/14/2009
Active	Madison National Life Insurance Company Inc.	301458	Agent - Life	8/14/2009
Inactive	Mutual Trust Life Insurance Company, A Pan-American Life Insurance Group Stock Company	300585	Agent - Life	3/3/2016	12/31/2022
Inactive	Nassau Life Insurance Company of Texas	300872	Agent - Health	7/10/2004	12/30/2005
Inactive	Nassau Life Insurance Company of Texas	300872	Agent - Life	7/10/2004	1/7/2014
Inactive	National Guardian Life Insurance Company	300596	Agent - Health	8/25/2003	2/26/2007
Inactive	National Guardian Life Insurance Company	300596	Agent - Life	8/25/2003	2/26/2007
Active	National Health Insurance Company	300554	Agent - Health	11/14/2023
Active	National Health Insurance Company	300554	Agent - Life	11/14/2023
Inactive	National Western Life Insurance Company	301515	Agent - Life	2/5/2014	6/20/2019
Inactive	Pan-American Assurance Company	301533	Agent - Health	12/30/2003	5/5/2005
Inactive	Pan-American Assurance Company	301533	Agent - Life	12/30/2003	5/5/2005
Inactive	Pan-American Life Insurance Company	301530	Agent - Health	12/30/2003	5/5/2005
Active	Pan-American Life Insurance Company	301530	Agent - Life	12/31/2022
Inactive	Reserve National Insurance Company	301073	Agent - Health	10/2/2013	9/3/2019
Inactive	Reserve National Insurance Company	301073	Agent - Life	10/2/2013	9/3/2019
Inactive	Securian Life Insurance Company	300757	Agent - Health	1/17/2007	5/21/2018
Inactive	Securian Life Insurance Company	300757	Agent - Life	1/17/2007	5/21/2018
Inactive	Sentry Life Insurance Company	301461	Agent - Health	3/27/2015	10/13/2016
Inactive	Sentry Life Insurance Company	301461	Agent - Life	3/27/2015	10/13/2016

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Hildebrand, Edwin A	324810	Agent - Health	2/14/2005
Active	Hildebrand, Edwin A	324810	Agent - Life	2/14/2005
Inactive	Johnson, Phillip K	645564	Agent - Health	1/26/2007	9/13/2016
Inactive	Johnson, Phillip K	645564	Agent - Life	1/26/2007	9/13/2016
Active	Russo, James Henry	393659	Agent - Health	2/14/2005
Active	Russo, James Henry	393659	Agent - Life	2/14/2005
Active	Stolz, Richard Walter	515005	Agent - Health	10/12/2016
Active	Stolz, Richard Walter	515005	Agent - Life	9/13/2016