DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Sandgren, John G	DOIID	643466	NAIC NPN	8955595

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	3/9/2011	2/4/2013
Inactive	Non Resident	Agent	Health	3/9/2011	2/4/2013
* 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	CMFG Life Insurance Company	300929	Agent - Health	11/15/2006	6/20/2008
Inactive	CMFG Life Insurance Company	300929	Agent - Life	11/15/2006	6/20/2008
Inactive	CUNA Mutual Life Insurance Company	301467	Agent - Health	11/15/2006	12/31/2007
Inactive	CUNA Mutual Life Insurance Company	301467	Agent - Life	11/15/2006	12/31/2007
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	3/16/2011	5/23/2012
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/16/2011	5/23/2012
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/16/2011	5/23/2012
Inactive	Humana Insurance Company	301104	Agent - Health	3/17/2012	5/23/2012
Inactive	Humana Insurance Company	301104	Agent - Life	3/17/2012	5/23/2012
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	3/16/2011	5/23/2012
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	3/16/2011	5/23/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Health	3/16/2011	5/23/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	3/16/2011	5/23/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	3/16/2011	5/23/2012
Inactive	Kanawha Insurance Company	300127	Agent - Life	3/16/2011	5/23/2012
Inactive	Time Insurance Company	300683	Agent - Health	10/11/2011	2/4/2013
Inactive	Time Insurance Company	300683	Agent - Life	10/11/2011	2/4/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Humana MarketPOINT Inc.	398092	Agent - Life	7/20/2011	2/4/2013
Inactive	Humana MarketPOINT Inc.	398092	Agent - Health	7/20/2011	2/4/2013