DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Moore, Mark A	DOIID	620262	NAIC NPN	8649779

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	12/13/2005	12/1/2007
Inactive	Resident	Agent	Health	12/13/2005	12/1/2007
* 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	3/29/2006	12/1/2007
Inactive	Anthem Life Insurance Company	301209	Agent - Life	3/29/2006	12/1/2007
Inactive	Northwestern Long Term Care Insurance Company	300135	Agent - Health	2/7/2006	1/8/2007
Inactive	Northwestern Mutual Life Insurance Company	300931	Agent - Health	12/13/2005	1/8/2007
Inactive	Northwestern Mutual Life Insurance Company	300931	Agent - Life	12/13/2005	1/8/2007
Inactive	Protective Life Insurance Company	300638	Agent - Health	10/4/2006	12/1/2007
Inactive	Protective Life Insurance Company	300638	Agent - Life	10/4/2006	12/1/2007

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	3/29/2006	12/1/2007
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	3/29/2006	12/1/2007