DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Mullner, Terry W	DOIID	717987	NAIC NPN	1716686

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	11/12/2009	9/30/2011
Inactive	Non Resident	Agent	Life	11/12/2009	9/30/2011
* 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	Starr Indemnity and Liability Company	301685	Agent - Health	7/22/2010	9/30/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Starr Assist LLC	653963	Agent - Health	9/10/2010	1/10/2011