DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Burrell, Antonio	DOIID	682573	NAIC NPN	8817513

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	6/11/2008	6/1/2011
Inactive	Non Resident	Agent	Health	6/11/2008	6/1/2011
* 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	Anthem Life Insurance Company	301209	Agent - Health	11/18/2009	6/1/2011
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/18/2009	6/1/2011
Inactive	Colonial Penn Life Insurance Company	300491	Agent - Health	7/29/2008	9/17/2008
Inactive	Colonial Penn Life Insurance Company	300491	Agent - Life	7/29/2008	9/17/2008
Inactive	Wellpoint Life and Health Insurance Company	300469	Agent - Health	3/5/2010	6/1/2011
Inactive	Wellpoint Life and Health Insurance Company	300469	Agent - Life	3/5/2010	6/1/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Corporate Call Center, Inc	695480	Agent - Health	11/18/2009	6/1/2011
Inactive	Corporate Call Center, Inc	695480	Agent - Life	11/18/2009	6/1/2011