DEPARTMENT OF INSURANCE

Affiliations

Name	Wallace, Timothy E	DOIID	689256	NAIC NPN	3896754

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	9/16/2008	6/8/2012
Inactive	Non Resident	Agent	Health	10/10/2013	4/30/2015
* 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	12/1/2008	7/27/2010
Inactive	Aetna Life Insurance Company	301140	Agent - Health	12/1/2008	7/27/2010
Inactive	Aetna Life Insurance Company	301140	Agent - Life	12/1/2008	7/27/2010
Inactive	Anthem Life Insurance Company	301209	Agent - Health	7/16/2009	3/1/2011
Inactive	Anthem Life Insurance Company	301209	Agent - Life	7/16/2009	3/1/2011
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	10/15/2013	11/14/2013
Inactive	Continental American Insurance Company	301700	Agent - Health	9/13/2011	6/8/2012
Inactive	Continental American Insurance Company	301700	Agent - Life	9/13/2011	6/8/2012
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	10/15/2013	11/14/2013
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/15/2013	11/14/2013
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/11/2013	11/6/2014
Inactive	Humana Insurance Company	301104	Agent - Health	10/11/2013	11/6/2014
Inactive	Humana Insurance Company	301104	Agent - Life	1/11/2011	3/17/2011
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/15/2013	11/14/2013
Inactive	Kanawha Insurance Company	300127	Agent - Health	10/15/2013	11/14/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	10/5/2011	6/8/2012
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	1/18/2011	4/4/2012
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	7/24/2009	6/8/2012
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	7/24/2009	6/8/2012
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	7/24/2009	6/8/2012
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	7/24/2009	6/8/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	1/18/2011	4/4/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	1/18/2011	4/4/2012
Inactive	Wellpoint Life and Health Insurance Company	300469	Agent - Health	12/8/2008	4/29/2010
Inactive	Wellpoint Life and Health Insurance Company	300469	Agent - Life	12/8/2008	4/29/2010

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	7/16/2009	6/8/2012
Inactive	Corporate Call Center, Inc	695480	Agent - Life	7/16/2009	6/8/2012