DEPARTMENT OF INSURANCE
Affiliations
NameGroom, Ralph GlenDOIID562809NAIC NPN750343
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentLife2/6/20033/31/2007 
InactiveNon ResidentAgentHealth2/6/20033/31/2007 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveBoston Mutual Life Insurance Company300143Agent - Health3/5/20033/31/2007
InactiveBoston Mutual Life Insurance Company300143Agent - Life3/5/20033/31/2007
InactiveKanawha Insurance Company300127Agent - Health4/28/20053/31/2007
InactiveKanawha Insurance Company300127Agent - Life4/28/20053/31/2007
InactiveReliaStar Life Insurance Company301712Agent - Health2/6/20033/31/2007
InactiveReliaStar Life Insurance Company301712Agent - Life2/6/20033/31/2007
InactiveReliaStar Life Insurance Company of New York301018Agent - Health2/6/20033/31/2007
InactiveReliaStar Life Insurance Company of New York301018Agent - Life2/6/20033/31/2007
InactiveTrustmark Insurance Company300317Agent - Health6/5/20053/12/2007
InactiveTrustmark Insurance Company300317Agent - Life6/5/20053/12/2007
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveThe Farmington Company534046Agent - Health8/18/20033/31/2007
InactiveThe Farmington Company534046Agent - Life8/18/20033/31/2007

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