DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Countryman, Peter B	DOIID	703479	NAIC NPN	7826577

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	4/9/2009	7/31/2012
Inactive	Non Resident	Agent	Life	4/9/2009	7/31/2012
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	9/26/2009	7/20/2012
Inactive	Aetna Life Insurance Company	301140	Agent - Health	9/26/2009	7/20/2012
Inactive	Aetna Life Insurance Company	301140	Agent - Life	9/26/2009	7/20/2012
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	8/14/2009	12/21/2011
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	8/14/2009	12/21/2011
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	8/18/2011	7/31/2012
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	8/18/2011	7/31/2012
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	8/14/2009	8/10/2012
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	8/14/2009	8/10/2012
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	8/20/2009	7/31/2012
Inactive	Humana Insurance Company	301104	Agent - Health	8/20/2009	7/31/2012
Inactive	Humana Insurance Company	301104	Agent - Life	8/20/2009	7/31/2012
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	8/18/2011	7/31/2012
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	8/18/2011	7/31/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Health	4/13/2011	7/31/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	4/13/2011	7/31/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	8/20/2009	7/31/2012
Inactive	Kanawha Insurance Company	300127	Agent - Life	8/20/2009	7/31/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Keystone Ins & Benefits Group LLC	716920	Agent - Life	3/27/2012	7/31/2012
Inactive	Keystone Ins & Benefits Group LLC	716920	Agent - Health	3/27/2012	7/31/2012
Inactive	Mcgowan Ins Group Inc	534567	Agent - Life	9/14/2009	7/31/2012
Inactive	Mcgowan Ins Group Inc	534567	Agent - Health	9/14/2009	7/31/2012