DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Smith, Chad M	DOIID	754187	NAIC NPN	6527322

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	5/11/2011	8/31/2015
Inactive	Non Resident	Agent	Life	5/11/2011	8/31/2015
* 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	Anthem Life Insurance Company	301209	Agent - Health	8/4/2011	8/31/2015
Inactive	Anthem Life Insurance Company	301209	Agent - Life	8/4/2011	8/31/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	8/4/2011	8/31/2015
Inactive	Designated Agent Company Inc.	681257	Agent - Health	8/4/2011	8/31/2015
Inactive	Milestone Benefits Agcy Inc	753584	Agent - Life	8/4/2011	3/15/2013
Inactive	Milestone Benefits Agcy Inc	753584	Agent - Health	8/4/2011	3/15/2013