DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Shiomos, Michael	DOIID	599289	NAIC NPN	1231450

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	6/13/2006	8/31/2014
Inactive	Non Resident	Agent	Health	6/13/2006	8/31/2014
Denied	Non Resident	Managing General Agent	Not Applicable
* 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	Allianz Life Insurance Company of North America	301791	Agent - Health	3/12/2009	9/5/2011
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	3/12/2009	9/5/2011
Inactive	Freedom Life Insurance Company of America	300074	Agent - Health	6/20/2006	1/5/2009
Inactive	Freedom Life Insurance Company of America	300074	Agent - Life	6/20/2006	1/5/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Seabury & Smith Inc	394854	Agent - Health	3/29/2011	9/5/2011
Inactive	Seabury & Smith Inc	394854	Agent - Life	3/29/2011	9/5/2011