DEPARTMENT OF INSURANCE

Affiliations

Name	Fuller, Susan B	DOIID	719991	NAIC NPN	3239014

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	1/27/2010	1/6/2015
Inactive	Non Resident	Agent	Life	1/27/2010	1/6/2015
* 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	3/5/2010	3/11/2015
Inactive	Aetna Life Insurance Company	301140	Agent - Health	3/5/2010	3/11/2015
Inactive	Aetna Life Insurance Company	301140	Agent - Life	3/5/2010	3/11/2015
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	9/5/2012	1/23/2013
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	9/5/2012	1/23/2013
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	3/19/2010	2/6/2015
Inactive	CompBenefits Insurance Company	301864	Agent - Health	3/19/2010	6/26/2013
Inactive	CompBenefits Insurance Company	301864	Agent - Life	3/19/2010	6/26/2013
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/19/2010	2/6/2015
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	6/20/2012	6/27/2012
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	3/3/2010	11/23/2012
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	3/3/2010	11/23/2012
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	8/12/2014	2/6/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/19/2010	2/6/2015
Inactive	Humana Insurance Company	301104	Agent - Health	3/19/2010	2/6/2015
Inactive	Humana Insurance Company	301104	Agent - Life	3/19/2010	2/6/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	3/19/2010	2/6/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	3/19/2010	2/6/2015
Inactive	HumanaDental Insurance Company	301457	Agent - Health	3/19/2010	2/23/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	3/19/2010	2/23/2012
Inactive	John Alden Life Insurance Company	300573	Agent - Health	2/21/2010	1/24/2013
Inactive	John Alden Life Insurance Company	300573	Agent - Life	2/21/2010	1/24/2013
Inactive	Kanawha Insurance Company	300127	Agent - Health	3/19/2010	2/6/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	3/19/2010	2/6/2015
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	9/20/2011	3/17/2015
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	9/20/2011	3/17/2015
Inactive	Principal Life Insurance Company	300129	Agent - Health	8/20/2012	1/6/2015
Inactive	Principal Life Insurance Company	300129	Agent - Life	8/20/2012	1/6/2015
Inactive	Time Insurance Company	300683	Agent - Health	10/22/2012	12/20/2014
Inactive	Time Insurance Company	300683	Agent - Life	10/22/2012	12/20/2014
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	9/28/2012	1/6/2015
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	9/28/2012	1/6/2015
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	4/26/2012	1/6/2015
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	5/21/2012	1/6/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CBISA Reaquisitian Corp	547026	Agent - Life	2/22/2010	1/6/2015
Inactive	CBISA Reaquisitian Corp	547026	Agent - Health	2/22/2010	1/6/2015
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/10/2013	1/6/2015
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/10/2013	1/6/2015
Inactive	Phelan Insurance Agency Inc.	512633	Agent - Life	10/24/2011	1/6/2015
Inactive	Phelan Insurance Agency Inc.	512633	Agent - Health	10/24/2011	1/6/2015