DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Devine, Ronald M	DOIID	596908	NAIC NPN	1713788

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/13/2004	9/30/2009
Inactive	Non Resident	Agent	Life	10/13/2004	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	Anthem Life Insurance Company	301209	Agent - Health	1/2/2005	9/30/2009
Inactive	Anthem Life Insurance Company	301209	Agent - Life	1/2/2005	9/30/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CBIZ Benefits & Ins Services Inc	514101	Agent - Health	2/17/2005	9/30/2009
Inactive	CBIZ Benefits & Ins Services Inc	514101	Agent - Life	2/17/2005	9/30/2009