DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Dawson IV, Wallace H	DOIID	593971	NAIC NPN	515854

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	8/16/2004	1/31/2024
Inactive	Non Resident	Agent	Health	8/16/2004	1/31/2024
* 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	Humana Health Plan, Inc.	300142	Agent - Health	9/9/2016	4/20/2018
Inactive	Humana Insurance Company	301104	Agent - Health	11/12/2004	7/10/2013
Inactive	Humana Insurance Company	301104	Agent - Life	11/12/2004	7/10/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/9/2016	4/20/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/9/2016	4/20/2018
Inactive	Kanawha Insurance Company	300127	Agent - Health	8/17/2011	4/25/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	8/17/2011	4/25/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Trisure Corporation	588786	Agent - Health	11/12/2004	8/26/2019
Inactive	Trisure Corporation	588786	Agent - Life	11/12/2004	8/26/2019