DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Veeneman, Donna Marie	DOIID	621560	NAIC NPN	8665167

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	6/2/2011	8/1/2012
Inactive	Resident	Agent	Casualty	3/8/2011	8/1/2012
Inactive	Resident	Agent	Property	3/8/2011	8/1/2012
Inactive	Resident	Agent	Health	3/8/2011	8/1/2012
* 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	Bridgefield Casualty Insurance Company	500013	Agent - Casualty	6/5/2007	8/1/2010
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	11/18/2008	8/1/2010
Inactive	Bristol West Insurance Company	301655	Agent - Property	11/18/2008	8/1/2010
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	7/9/2010	8/1/2010
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	8/1/2010
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	12/9/2008	8/1/2010
Inactive	Humana Insurance Company	301104	Agent - Health	12/9/2008	8/1/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	12/9/2008	8/1/2010
Inactive	HumanaDental Insurance Company	301457	Agent - Health	12/9/2008	8/1/2010
Inactive	Kanawha Insurance Company	300127	Agent - Health	12/9/2008	8/1/2010
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Casualty	2/8/2006	1/12/2010
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Property	2/8/2006	1/12/2010
Inactive	State Farm Fire and Casualty Company	301809	Agent - Casualty	3/8/2011	4/25/2012
Inactive	State Farm Fire and Casualty Company	301809	Agent - Property	3/8/2011	4/25/2012
Inactive	State Farm Life Insurance Company	301810	Agent - Life	6/2/2011	4/25/2012
Inactive	State Farm Mutual Automobile Insurance Company	301732	Agent - Casualty	3/8/2011	4/25/2012
Inactive	State Farm Mutual Automobile Insurance Company	301732	Agent - Health	3/8/2011	4/25/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Gerald Schott Agency Inc. [The]	398924	Agent - Casualty	2/8/2006	8/18/2006
Inactive	Gerald Schott Agency Inc. [The]	398924	Agent - Property	2/8/2006	8/18/2006
Inactive	Kiely Hines & Associates Insurance Agency Inc.	399757	Agent - Casualty	9/28/2006	8/1/2010
Inactive	Kiely Hines & Associates Insurance Agency Inc.	399757	Agent - Property	9/28/2006	8/1/2010