DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Groth, Kathleen A	DOIID	594951	NAIC NPN	1040145

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	9/2/2004	9/30/2009
Inactive	Non Resident	Agent	Health	9/2/2004	9/30/2009
* 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	Augustar Life Assurance Corporation	301113	Agent - Health	7/19/2005	12/10/2006
Inactive	Augustar Life Assurance Corporation	301113	Agent - Life	7/19/2005	12/10/2006
Inactive	Augustar Life Insurance Company	301816	Agent - Health	7/19/2005	12/10/2006
Inactive	Augustar Life Insurance Company	301816	Agent - Life	7/19/2005	12/10/2006
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	12/7/2007	9/30/2009
Inactive	Columbus Life Insurance Company	301227	Agent - Health	10/5/2005	9/30/2009
Inactive	Columbus Life Insurance Company	301227	Agent - Life	10/5/2005	9/30/2009
Inactive	Genworth Life Insurance Company	300623	Agent - Health	8/20/2005	12/4/2007
Inactive	Genworth Life Insurance Company	300623	Agent - Life	8/20/2005	12/4/2007
Inactive	Integrity Life Insurance Company	301687	Agent - Life	3/5/2007	9/30/2009
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	3/29/2005	6/7/2008
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	3/29/2005	6/7/2008
Inactive	Lafayette Life Insurance Company (The)	301039	Agent - Health	2/6/2006	9/30/2009
Inactive	Lafayette Life Insurance Company (The)	301039	Agent - Life	2/6/2006	9/30/2009
Inactive	MetLife Life and Annuity Company of Connecticut	301593	Agent - Life	8/24/2005	12/7/2007
Inactive	Protective Life Insurance Company	300638	Agent - Health	3/3/2005	2/20/2006
Inactive	Protective Life Insurance Company	300638	Agent - Life	3/3/2005	2/20/2006
Inactive	West Coast Life Insurance Company	301607	Agent - Life	3/30/2005	12/29/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Divinity Group Inc.	594624	Agent - Life	3/3/2005	3/31/2008
Inactive	Divinity Group Inc.	594624	Agent - Health	3/3/2005	3/31/2008