DEPARTMENT OF INSURANCE

Affiliations

Name	Cardinal Brokerage Ins Agcy Inc	DOIID	713665	NAIC NPN	2212704

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Denied	Non Resident	Agent	Variable Life and Variable Annuities
Inactive	Non Resident	Agent	Life	9/17/2009	3/31/2013
Inactive	Non Resident	Agent	Health	9/17/2009	3/31/2013
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	2/15/2010	11/4/2011
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	11/20/2009	3/31/2013
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	11/20/2009	3/31/2013
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	11/20/2009	3/31/2013
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	11/20/2009	3/31/2013

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Burgoon, Roy M	698063	Agent - Health	9/17/2009	3/31/2013
Inactive	Burgoon, Roy M	698063	Agent - Life	9/17/2009	3/31/2013
Inactive	Williamson, Ralph Lyal	355830	Agent - Variable Life and Variable Annuities	9/23/2009	11/2/2009