DEPARTMENT OF INSURANCE

Affiliations

Name	Fahlman Jr, Robert Lawrence	DOIID	591268	NAIC NPN	8146700

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	6/21/2004	6/15/2010
Inactive	Non Resident	Agent	Health	6/21/2004	6/15/2010
* 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	Ameritas Life Insurance Corporation	300126	Agent - Health	3/21/2005	6/15/2010
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Life	3/21/2005	6/15/2010
Inactive	Anthem Life Insurance Company	301209	Agent - Health	10/1/2004	6/25/2009
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/1/2004	6/25/2009
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	6/3/2008	6/15/2010
Inactive	CompBenefits Insurance Company	301864	Agent - Health	6/3/2008	6/15/2010
Inactive	CompBenefits Insurance Company	301864	Agent - Life	6/3/2008	6/15/2010
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/21/2005	6/15/2010
Inactive	Fairmont Premier Insurance Company	300892	Agent - Health	11/5/2004	10/5/2006
Inactive	Golden Rule Insurance Company	301943	Agent - Health	10/12/2004	6/15/2010
Inactive	Golden Rule Insurance Company	301943	Agent - Life	10/12/2004	6/15/2010
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/26/2009	6/15/2010
Inactive	Humana Insurance Company	301104	Agent - Health	12/13/2004	6/15/2010
Inactive	Humana Insurance Company	301104	Agent - Life	12/13/2004	6/15/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/23/2005	6/15/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/23/2005	6/15/2010
Inactive	HumanaDental Insurance Company	301457	Agent - Health	2/26/2007	6/15/2010
Inactive	HumanaDental Insurance Company	301457	Agent - Life	2/26/2007	6/15/2010
Inactive	John Alden Life Insurance Company	300573	Agent - Health	5/13/2005	6/15/2010
Inactive	John Alden Life Insurance Company	300573	Agent - Life	5/13/2005	6/15/2010
Inactive	Madison National Life Insurance Company Inc.	301458	Agent - Health	12/4/2006	6/15/2010
Inactive	Madison National Life Insurance Company Inc.	301458	Agent - Life	12/4/2006	6/15/2010
Inactive	North River Insurance Company (The)	301739	Agent - Health	10/3/2006	6/15/2010
Inactive	Time Insurance Company	300683	Agent - Health	4/26/2005	6/15/2010
Inactive	Time Insurance Company	300683	Agent - Life	4/26/2005	6/15/2010
Inactive	Union Security Insurance Company	301844	Agent - Health	4/20/2006	6/15/2010
Inactive	Union Security Insurance Company	301844	Agent - Life	4/20/2006	6/15/2010
Inactive	United States Fire Insurance Company	582240	Agent - Health	10/3/2006	6/15/2010
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	2/22/2005	12/14/2009
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	2/22/2005	12/14/2009
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	2/14/2005	6/1/2007
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	2/14/2005	6/1/2007
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	2/22/2005	12/14/2009
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	2/22/2005	12/14/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	eHealthInsurance Services Inc.	514105	Agent - Health	10/21/2004	6/15/2010
Inactive	eHealthInsurance Services Inc.	514105	Agent - Life	10/21/2004	6/15/2010