DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Gowen, Daniel	DOIID	582620	NAIC NPN	2836763

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	1/6/2004	2/28/2007
Inactive	Non Resident	Agent	Life	1/6/2004	2/28/2007
* 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

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	5/10/2004	12/12/2005
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	5/10/2004	12/12/2005
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	5/10/2004	12/12/2005
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	5/10/2004	12/12/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Marsh USA Inc	587537	Agent - Health	6/10/2004	12/12/2005
Inactive	Marsh USA Inc	587537	Agent - Life	6/10/2004	12/12/2005
Denied	Mercer Health & Benefits LLC	607080	Agent - Health
Denied	Mercer Health & Benefits LLC	607080	Agent - Life