DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Grenolds Jr, Dale S	DOIID	569055	NAIC NPN	2354767

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Administrator	Not Applicable	2/26/2008	1/31/2012
Inactive	Non Resident	Agent	Health	5/2/2003	1/31/2012
* 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	Aetna Health Inc.	300694	Agent - Health	5/2/2003	12/31/2007
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	12/31/2007	1/31/2012
Inactive	Aetna Life Insurance Company	301140	Agent - Health	5/2/2003	1/31/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aetna Student Health Agency Inc	521725	Agent - Health	1/30/2004	1/31/2012
Inactive	Chickering Claims Administrators Inc	513568	Administrator - Not Applicable	4/1/2008	1/31/2012