DEPARTMENT OF INSURANCE

Affiliations

Name	Menza, Daniel Richard	DOIID	648019	NAIC NPN	5939942

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	1/22/2007	10/31/2011
Inactive	Non Resident	Agent	Life	1/22/2007	10/31/2011
* 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	Assurity Life Insurance Company	301099	Agent - Health	8/15/2009	9/20/2010
Inactive	Assurity Life Insurance Company	301099	Agent - Life	8/15/2009	9/20/2010
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	9/1/2011	10/31/2011
Inactive	Delaware Life Insurance Company	301256	Agent - Life	6/4/2007	11/3/2009
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/1/2011	10/31/2011
Inactive	Genworth Life Insurance Company	300623	Agent - Health	3/8/2007	10/4/2009
Inactive	Genworth Life Insurance Company	300623	Agent - Life	3/8/2007	10/4/2009
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/1/2011	10/31/2011
Inactive	Humana Insurance Company	301104	Agent - Health	9/1/2011	10/31/2011
Inactive	Humana Insurance Company	301104	Agent - Life	9/1/2011	10/31/2011
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/1/2011	10/31/2011
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/1/2011	10/31/2011
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/1/2011	10/31/2011
Inactive	Kanawha Insurance Company	300127	Agent - Life	9/1/2011	10/31/2011
Inactive	Medico Insurance Company	301559	Agent - Health	4/21/2010	12/29/2010
Inactive	Medico Insurance Company	301559	Agent - Life	4/21/2010	12/29/2010
Inactive	Midland National Life Insurance Company	300923	Agent - Health	1/23/2007	10/10/2007
Inactive	Midland National Life Insurance Company	300923	Agent - Life	1/23/2007	10/10/2007
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	4/5/2007	4/6/2010
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Life	4/5/2007	10/31/2011
Inactive	Time Insurance Company	300683	Agent - Health	2/6/2008	10/31/2011
Inactive	Time Insurance Company	300683	Agent - Life	2/6/2008	10/31/2011
Inactive	United World Life Insurance Company	300532	Agent - Health	4/26/2007	10/31/2011
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	7/6/2009	4/28/2010
Inactive	West Coast Life Insurance Company	301607	Agent - Health	1/31/2007	12/15/2008
Inactive	West Coast Life Insurance Company	301607	Agent - Life	1/31/2007	12/15/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	2/18/2009	10/31/2011