DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Ellis, Ann Bernice	DOIID	653843	NAIC NPN	9152128

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	4/19/2007	11/17/2009
Inactive	Non Resident	Agent	Life	4/19/2007	11/17/2009
* 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	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	6/1/2007	11/17/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Financial Insurance Services, Inc.	514710	Agent - Life
Inactive	Financial Insurance Services, Inc.	514710	Agent - Health	7/20/2007	11/9/2007