DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Dougherty, Michael Ross	DOIID	589995	NAIC NPN	8103678

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	4/3/2007	1/1/2014
Inactive	Resident	Agent	Health	6/8/2004	12/31/2005
* 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 General Life Insurance Company	301585	Agent - Life	12/31/2012	3/21/2013
Inactive	Empower Annuity Insurance Company of America	300259	Agent - Life	3/28/2008	3/14/2013
Inactive	Lincoln Life Assurance Company of Boston	301915	Agent - Life	5/19/2011	5/9/2013
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Life	4/16/2007	3/13/2013
Inactive	Northwestern Mutual Life Insurance Company	300931	Agent - Health	6/8/2004	3/8/2005
Inactive	Northwestern Mutual Life Insurance Company	300931	Agent - Life	6/8/2004	3/8/2005
Inactive	Pacific Life Insurance Company	301848	Agent - Life	9/14/2009	1/1/2014
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	4/13/2007	4/15/2013
Inactive	Western National Life Insurance Company	300461	Agent - Life	4/13/2007	12/31/2012
Inactive	Western-Southern Life Assurance Company	301590	Agent - Life	3/4/2010	4/1/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	U S Bancorp Ins Services L L C	400253	Agent - Life	4/16/2007	3/12/2013
Inactive	US Bancorp Investments, Inc.	572662	Agent - Life	4/16/2007	3/12/2013