DEPARTMENT OF INSURANCE

Affiliations

Name	Ellis, Carolyn L	DOIID	586773	NAIC NPN	7684698

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	4/25/2007	8/31/2009
Inactive	Non Resident	Agent	Life	4/25/2007	8/31/2009
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	StoneBridge Insurance Services, Inc	398862	Agent - Health
Denied	StoneBridge Insurance Services, Inc	398862	Agent - Life