DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Johnson, Theodore Daniel	DOIID	678627	NAIC NPN	8849707

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	4/17/2008	2/28/2017
* 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	Madison National Life Insurance Company Inc.	301458	Agent - Health	5/29/2008	1/8/2010
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Health	4/25/2008	2/28/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Trustway T E A M Inc	671543	Agent - Health	4/9/2009	3/31/2013