DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Lange, Mark	DOIID	731486	NAIC NPN	15747930

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	7/1/2010	6/30/2016
Inactive	Non Resident	Agent	Casualty	7/1/2010	6/30/2016
Inactive	Non Resident	Agent	Health	7/1/2010	6/30/2016
Inactive	Non Resident	Agent	Property	7/1/2010	6/30/2016
* 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 Health and Life Insurance Company	300844	Agent - Health	12/31/2014	12/31/2014
Inactive	American Health and Life Insurance Company	300844	Agent - Life	12/31/2014	12/31/2014
Inactive	Sears Life Insurance Company	300218	Agent - Health	9/28/2010	12/31/2014
Inactive	Sears Life Insurance Company	300218	Agent - Life	9/28/2010	12/31/2014
Inactive	Triton Insurance Company	300654	Agent - Casualty	9/27/2010	12/31/2014
Inactive	Triton Insurance Company	300654	Agent - Property	9/27/2010	12/31/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Sears Insurance Services, LLC	505860	Agent - Casualty	9/29/2010	3/31/2016
Inactive	Sears Insurance Services, LLC	505860	Agent - Life	9/29/2010	3/31/2016
Inactive	Sears Insurance Services, LLC	505860	Agent - Health	9/29/2010	3/31/2016
Inactive	Sears Insurance Services, LLC	505860	Agent - Property	9/29/2010	3/31/2016