DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Northam, Cheryl Ann	DOIID	589356	NAIC NPN	5314951

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	5/17/2004	9/10/2009
Inactive	Non Resident	Agent	Life	5/17/2004	9/10/2009
* 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	Continental Casualty Company	301019	Agent - Health	7/9/2004	12/15/2004
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	8/11/2004	9/9/2009
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	8/11/2004	9/9/2009
Inactive	Minnesota Life Insurance Company	300488	Agent - Health	6/3/2004	10/9/2008
Inactive	Minnesota Life Insurance Company	300488	Agent - Life	6/3/2004	10/9/2008
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	9/15/2005	9/10/2009
Inactive	Wilcac Life Insurance Company	301573	Agent - Health	7/9/2004	12/15/2004
Inactive	Wilcac Life Insurance Company	301573	Agent - Life	7/9/2004	12/15/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Financial Insurance Services, Inc.	514710	Agent - Health	5/19/2005	12/10/2007
Inactive	Financial Insurance Services, Inc.	514710	Agent - Life	5/19/2005	12/10/2007