DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Gill, Monique	DOIID	612042	NAIC NPN	8520527

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	8/15/2005	7/1/2007
Inactive	Resident	Agent	Health	8/12/2005	7/1/2007
* 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	Anthem Life Insurance Company	301209	Agent - Health	9/1/2005	7/1/2007
Inactive	Anthem Life Insurance Company	301209	Agent - Life	9/1/2005	7/1/2007
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	9/26/2005	7/1/2007
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	9/26/2005	7/1/2007

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Benefit Ins Marketing Inc	398449	Agent - Health	9/1/2005	1/23/2007
Inactive	Benefit Ins Marketing Inc	398449	Agent - Life	9/1/2005	1/23/2007