DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Rose, Michael David	DOIID	687654	NAIC NPN	5966320

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	8/23/2008	12/31/2009
Inactive	Non Resident	Agent	Health	8/23/2008	12/31/2009
* 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	Anthem Life Insurance Company	301209	Agent - Health	1/16/2009	12/31/2009
Inactive	Anthem Life Insurance Company	301209	Agent - Life	1/16/2009	12/31/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Safeway Financial LLC	653399	Agent - Life	1/16/2009	12/31/2009
Inactive	Safeway Financial LLC	653399	Agent - Health	1/16/2009	12/31/2009