DEPARTMENT OF INSURANCE

Affiliations

Name	Pettus, Adam Wayne	DOIID	686424	NAIC NPN	10946657

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	8/6/2008	11/30/2013
Inactive	Non Resident	Agent	Life	8/6/2008	11/30/2013
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	10/30/2008	5/26/2009
Inactive	Aetna Life Insurance Company	301140	Agent - Health	10/30/2008	5/26/2009
Inactive	Aetna Life Insurance Company	301140	Agent - Life	10/30/2008	5/26/2009
Inactive	American Continental Insurance Company	643130	Agent - Health	10/15/2008	11/30/2013
Inactive	American Continental Insurance Company	643130	Agent - Life	10/15/2008	11/30/2013
Inactive	Anthem Life Insurance Company	301209	Agent - Health	12/10/2008	11/30/2013
Inactive	Anthem Life Insurance Company	301209	Agent - Life	12/10/2008	11/30/2013
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	2/10/2012	9/3/2013
Inactive	Coventry Health and Life Insurance Company	301771	Agent - Health	12/24/2008	9/9/2009
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	2/10/2012	9/3/2013
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	12/24/2008	9/9/2009
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/12/2012	9/3/2013
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/14/2011	9/3/2013
Inactive	Humana Insurance Company	301104	Agent - Health	11/17/2010	9/3/2013
Inactive	Humana Insurance Company	301104	Agent - Life	11/17/2010	9/3/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/14/2011	9/3/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	2/10/2012	9/3/2013
Inactive	Independent Order of Foresters	300743	Agent - Health	4/8/2013	11/30/2013
Inactive	Independent Order of Foresters	300743	Agent - Life	4/8/2013	11/30/2013
Inactive	Kanawha Insurance Company	300127	Agent - Health	10/12/2012	9/3/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	10/12/2012	9/3/2013
Inactive	Reserve National Insurance Company	301073	Agent - Health	4/15/2013	11/30/2013
Inactive	Reserve National Insurance Company	301073	Agent - Life	4/15/2013	11/30/2013
Inactive	SILAC Insurance Company	300535	Agent - Health	4/14/2009	1/3/2011
Inactive	SILAC Insurance Company	300535	Agent - Life	4/8/2013	11/30/2013
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	2/28/2011	11/15/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	2/28/2011	11/15/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Haberstroh Insurance Agency Inc	677010	Agent - Life	1/5/2009	11/30/2013
Inactive	Haberstroh Insurance Agency Inc	677010	Agent - Health	1/5/2009	11/30/2013