DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Thiel, Michael Jack	DOIID	574963	NAIC NPN	1612331

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	8/22/2003	5/31/2011
Inactive	Non Resident	Agent	Health	8/22/2003	5/31/2011
* 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	CompBenefits Dental, Inc.	591692	Agent - Health	7/9/2010	5/31/2011
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	5/31/2011
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/20/2009	5/31/2011
Inactive	Humana Insurance Company	301104	Agent - Health	3/3/2004	5/31/2011
Inactive	Humana Insurance Company	301104	Agent - Life	3/3/2004	5/31/2011
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	11/12/2004	6/11/2007
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	11/12/2004	6/11/2007

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	USI Insurance Services National, Inc	509421	Agent - Health	2/1/2010	5/31/2011
Inactive	USI Insurance Services National, Inc	509421	Agent - Life	2/1/2010	5/31/2011
Inactive	Wells Fargo Insurance Services Mountain West, Inc.	533395	Agent - Health	3/3/2004	2/1/2010
Inactive	Wells Fargo Insurance Services Mountain West, Inc.	533395	Agent - Life	3/3/2004	2/1/2010