DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Miller, Jeffrey Thomas	DOIID	646325	NAIC NPN	1474333

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	12/18/2006	10/13/2008
Inactive	Non Resident	Agent	Life	12/18/2006	10/13/2008
* 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	American General Life Insurance Company of Delaware	301057	Agent - Health	5/1/2007	10/13/2008
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Life	5/1/2007	10/13/2008
Inactive	Anthem Life Insurance Company	301209	Agent - Health	2/15/2007	10/13/2008
Inactive	Anthem Life Insurance Company	301209	Agent - Life	2/15/2007	10/13/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Wells Fargo Insurance Services of Indiana, LLC	524976	Agent - Health	2/15/2007	9/23/2008
Inactive	Wells Fargo Insurance Services of Indiana, LLC	524976	Agent - Life	2/15/2007	9/23/2008