DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Fukuda, Kei	DOIID	770945	NAIC NPN	15206675

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	12/16/2011	4/7/2014
Inactive	Non Resident	Agent	Health	12/16/2011	4/7/2014
* 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	CIGNA Dental Health of Kentucky, Inc.	300904	Agent - Health	2/9/2012	4/7/2014
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	2/9/2012	4/7/2014
Inactive	Connecticut General Life Insurance Company	301333	Agent - Life	2/9/2012	4/7/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Sumitomo Life Insurance Agency America, Inc.	612167	Agent - Life
Denied	Sumitomo Life Insurance Agency America, Inc.	612167	Agent - Health