DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Powless, David Allen	DOIID	572282	NAIC NPN	757617

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	7/2/2003	5/31/2009
Inactive	Non Resident	Agent	Health	7/2/2003	5/31/2009
* 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	Provident Life and Accident Insurance Company	301525	Agent - Health	2/24/2004	5/31/2009
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	2/24/2004	5/31/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Horton Group Inc The	582191	Agent - Health	12/28/2004	5/31/2009
Inactive	Horton Group Inc The	582191	Agent - Life	12/28/2004	5/31/2009