DEPARTMENT OF INSURANCE

Affiliations

Name	Brock, Nicole Emerance	DOIID	648693	NAIC NPN	9062540

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	2/8/2007	10/15/2010
Inactive	Resident	Agent	Life	2/6/2007	10/15/2010
* 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 Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	1/27/2009	2/22/2010
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	1/27/2009	2/22/2010
Denied	Anthem Life Insurance Company	301209	Agent - Health
Denied	Anthem Life Insurance Company	301209	Agent - Life
Inactive	Athene Annuity & Life Assurance Company	301798	Agent - Life	11/19/2007	8/13/2010
Inactive	Citizens Security Life Insurance Company	301257	Agent - Health	11/19/2007	10/15/2010
Inactive	Citizens Security Life Insurance Company	301257	Agent - Life	11/19/2007	10/15/2010
Inactive	Coventry Health and Life Insurance Company	301771	Agent - Health	3/10/2008	5/10/2010
Denied	First Health Life & Health Insurance Company	301735	Agent - Health
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Health	2/28/2008	10/15/2010
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Life	2/28/2008	10/15/2010
Inactive	Independent Order of Foresters	300743	Agent - Health	5/22/2008	12/3/2009
Inactive	Independent Order of Foresters	300743	Agent - Life	5/22/2008	12/3/2009
Denied	John Alden Life Insurance Company	300573	Agent - Health
Denied	John Alden Life Insurance Company	300573	Agent - Life
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	10/26/2007	12/30/2009
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	10/26/2007	12/30/2009
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	9/19/2008	10/15/2010
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	9/19/2008	10/15/2010
Inactive	MassMutual Ascend Life Insurance Company	300320	Agent - Health	12/21/2007	6/9/2009
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	11/21/2007	10/15/2010
Inactive	SILAC Insurance Company	300535	Agent - Health	5/21/2008	12/15/2009
Inactive	SILAC Insurance Company	300535	Agent - Life	5/21/2008	12/15/2009
Inactive	Shenandoah Life Insurance Company	300130	Agent - Health	3/13/2008	3/31/2009
Inactive	Shenandoah Life Insurance Company	300130	Agent - Life	3/13/2008	3/31/2009
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	2/8/2007	10/31/2007
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	2/6/2007	10/31/2007
Inactive	United Teacher Associates Insurance Company	300747	Agent - Health	2/19/2008	10/15/2010
Inactive	United Teacher Associates Insurance Company	300747	Agent - Life	2/19/2008	10/15/2010
Inactive	United World Life Insurance Company	300532	Agent - Health	11/21/2007	10/15/2010
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	12/12/2008	10/15/2010
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	12/12/2008	10/15/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	3/29/2007	10/31/2007
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	3/29/2007	10/31/2007
Inactive	Designated Agent Company Inc.	681257	Agent - Health	6/27/2008	10/15/2010
Inactive	Designated Agent Company Inc.	681257	Agent - Life	6/27/2008	10/15/2010