DEPARTMENT OF INSURANCE

Affiliations

Name	Gibson, Dale A	DOIID	696763	NAIC NPN	9624392

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	1/7/2009	6/30/2012
Inactive	Non Resident	Agent	Life	1/7/2009	6/30/2012
* 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	CompBenefits Dental, Inc.	591692	Agent - Health	3/5/2009	1/4/2011
Inactive	CompBenefits Insurance Company	301864	Agent - Health	3/5/2009	1/4/2011
Inactive	CompBenefits Insurance Company	301864	Agent - Life	3/5/2009	1/4/2011
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	8/6/2009	6/30/2012
Inactive	Connecticut General Life Insurance Company	301333	Agent - Life	8/6/2009	6/30/2012
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	1/4/2011
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/5/2009	1/4/2011
Inactive	Humana Insurance Company	301104	Agent - Health	3/5/2009	1/4/2011
Inactive	Humana Insurance Company	301104	Agent - Life	3/5/2009	1/4/2011
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	3/5/2009	1/4/2011
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	3/5/2009	1/4/2011
Inactive	HumanaDental Insurance Company	301457	Agent - Health	3/5/2009	1/4/2011
Inactive	HumanaDental Insurance Company	301457	Agent - Life	3/5/2009	1/4/2011
Inactive	Kanawha Insurance Company	300127	Agent - Health	3/5/2009	1/4/2011
Inactive	Kanawha Insurance Company	300127	Agent - Life	3/5/2009	1/4/2011
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	3/12/2009	11/6/2011
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Life	3/12/2009	7/17/2012
Inactive	Sterling Life Insurance Company	301947	Agent - Health	2/17/2009	11/1/2011
Inactive	United World Life Insurance Company	300532	Agent - Health	2/3/2009	12/15/2010
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	2/3/2009	6/30/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	2/3/2009	6/30/2012
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	3/12/2009	3/9/2012
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	3/12/2009	6/30/2012
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	8/2/2011	3/9/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Extend Insurance Services, LLC	625753	Agent - Health	2/9/2009	6/30/2012
Inactive	Extend Insurance Services, LLC	625753	Agent - Life	2/9/2009	6/30/2012