DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Keyser, Douglas	DOIID	715328	NAIC NPN	12797360

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/8/2009	8/31/2011
Inactive	Non Resident	Agent	Life	10/8/2009	8/31/2011
* 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	American National Insurance Company	301861	Agent - Health	11/13/2009	12/3/2009
Inactive	American National Insurance Company	301861	Agent - Life	11/13/2009	12/3/2009
Inactive	Minnesota Life Insurance Company	300488	Agent - Health	10/15/2009	8/12/2010
Inactive	Minnesota Life Insurance Company	300488	Agent - Life	10/15/2009	8/12/2010
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	10/13/2009	9/8/2010
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	10/13/2009	9/8/2010
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	10/13/2009	9/8/2010
Inactive	Principal Life Insurance Company	300129	Agent - Health	11/20/2009	8/31/2011
Inactive	Principal Life Insurance Company	300129	Agent - Life	11/20/2009	8/31/2011
Inactive	Western National Life Insurance Company	300461	Agent - Life	11/18/2009	8/31/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	W & R Insurance Agency	398729	Agent - Health	10/19/2009	8/5/2010
Inactive	W & R Insurance Agency	398729	Agent - Life	10/19/2009	8/5/2010