DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Senior American Insurance Services, LLC	DOIID	601102	NAIC NPN	8351324

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	1/24/2005	1/8/2007
Inactive	Resident	Agent	Life	1/24/2005	1/8/2007
* 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	Cigna National Health Insurance Company	300235	Agent - Health	2/11/2005	1/8/2007
Inactive	Cigna National Health Insurance Company	300235	Agent - Life	2/11/2005	1/8/2007
Inactive	Lincoln Heritage Life Insurance Company	500016	Agent - Health	1/26/2005	1/8/2007
Inactive	Lincoln Heritage Life Insurance Company	500016	Agent - Life	1/26/2005	1/8/2007
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	3/2/2005	1/8/2007
Inactive	Penn Treaty Network America Insurance Company	301297	Agent - Health	2/16/2005	1/8/2007
Inactive	Penn Treaty Network America Insurance Company	301297	Agent - Life	2/16/2005	1/8/2007
Inactive	United Teacher Associates Insurance Company	300747	Agent - Health	1/26/2005	1/8/2007
Inactive	United Teacher Associates Insurance Company	300747	Agent - Life	1/26/2005	1/8/2007
Inactive	United World Life Insurance Company	300532	Agent - Health	3/4/2005	1/8/2007
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	3/2/2005	1/8/2007
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	3/2/2005	1/8/2007

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Costellow, Glenda D	370200	Agent - Health
Inactive	Costellow, Glenda D	370200	Agent - Life	1/24/2005	1/8/2007
Inactive	Costellow, Wayburn Allen	347664	Agent - Health	1/24/2005	1/8/2007
Inactive	Costellow, Wayburn Allen	347664	Agent - Life	1/24/2005	1/8/2007
Inactive	McCoy, Bonita Faye	319743	Agent - Health	1/24/2005	1/8/2007
Inactive	McCoy, Bonita Faye	319743	Agent - Life	1/24/2005	1/8/2007
Inactive	Robinson, Jeremiah Ray	574094	Agent - Health	3/16/2005	1/31/2006
Inactive	Watson, William Todd	333502	Agent - Health	1/24/2005	1/8/2007
Inactive	Watson, William Todd	333502	Agent - Life	1/24/2005	1/8/2007