DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Eblen, David Howard	DOIID	584878	NAIC NPN	5944018

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	2/25/2004	1/31/2017
Inactive	Non Resident	Agent	Life	2/25/2004	1/31/2017
* 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	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	10/1/2004	9/15/2009
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	10/1/2004	9/15/2009
Inactive	American Fidelity Assurance Company	301004	Agent - Health	10/26/2004	12/6/2004
Inactive	American Fidelity Assurance Company	301004	Agent - Life	10/26/2004	12/6/2004
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	10/14/2004	9/16/2013
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	10/14/2004	9/16/2013
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	10/14/2004	1/31/2017
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	10/14/2004	1/31/2017
Inactive	Pacific Life & Annuity Company	300443	Agent - Health	11/16/2004	5/4/2006
Inactive	Pacific Life & Annuity Company	300443	Agent - Life	11/16/2004	5/4/2006
Inactive	Pacific Life Insurance Company	301848	Agent - Health	4/15/2004	1/31/2017
Inactive	Pacific Life Insurance Company	301848	Agent - Life	4/15/2004	1/31/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Insurance Planning & Service Co. Inc.	400509	Agent - Health	2/24/2005	3/16/2012
Inactive	Insurance Planning & Service Co. Inc.	400509	Agent - Life	2/24/2005	3/16/2012