DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Free, Dwight Willis	DOIID	586296	NAIC NPN	6607921

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	3/17/2004	8/31/2007
Inactive	Non Resident	Agent	Life	3/17/2004	8/31/2007
* 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	Union Labor Life Insurance Company	301832	Agent - Health	4/6/2004	1/3/2006
Inactive	Union Labor Life Insurance Company	301832	Agent - Life	4/6/2004	1/3/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Ullico Select LLC	502043	Agent - Life	2/10/2005	1/3/2006
Inactive	Ullico Select LLC	502043	Agent - Health	2/10/2005	1/3/2006