DEPARTMENT OF INSURANCE

Affiliations

Name	Tiller, Barry R	DOIID	630303	NAIC NPN	5956854

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	12/18/2007	8/1/2011
Inactive	Resident	Agent	Life	12/18/2007	8/1/2011
* 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 - Life	5/3/2010	8/27/2011
Inactive	Athene Annuity and Life Company	301893	Agent - Life	12/16/2009	8/30/2011
Inactive	CHA HMO, Inc.	300662	Agent - Health	1/11/2007	8/1/2007
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Health	1/3/2008	8/27/2011
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	1/3/2008	8/27/2011
Inactive	Companion Life Insurance Company	300191	Agent - Health	7/24/2006	8/1/2007
Inactive	Companion Life Insurance Company	300191	Agent - Life	7/24/2006	8/1/2007
Inactive	EMC National Life Company	300388	Agent - Health	2/20/2009	9/15/2009
Inactive	EMC National Life Company	300388	Agent - Life	2/20/2009	9/15/2009
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Health	12/15/2008	8/27/2011
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Life	12/15/2008	8/27/2011
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Health	2/12/2009	8/1/2011
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	2/12/2009	8/1/2011
Inactive	Golden Rule Insurance Company	301943	Agent - Health	2/13/2009	4/15/2009
Inactive	Golden Rule Insurance Company	301943	Agent - Life	2/13/2009	4/15/2009
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	1/27/2010	8/8/2011
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	1/27/2010	8/8/2011
Inactive	Professional Insurance Company	301281	Agent - Health	12/15/2006	8/1/2007
Inactive	Professional Insurance Company	301281	Agent - Life	12/15/2006	8/1/2007
Inactive	Pruco Life Insurance Company	300954	Agent - Health	11/18/2009	8/1/2011
Inactive	Pruco Life Insurance Company	300954	Agent - Life	11/18/2009	8/1/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	McConnell Insurance Agency Inc.	400140	Agent - Health	3/30/2007	8/1/2007
Inactive	McConnell Insurance Agency Inc.	400140	Agent - Life	3/30/2007	8/1/2007