DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Crain, Jacqueline	DOIID	837980	NAIC NPN	1062912

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	4/9/2014	3/31/2019
Inactive	Non Resident	Agent	Life	4/9/2014	3/31/2019
* 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	Northwestern Mutual Life Insurance Company	300931	Agent - Health	4/11/2014	1/9/2019
Inactive	Northwestern Mutual Life Insurance Company	300931	Agent - Life	4/11/2014	1/9/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Patriot Growth Insurance Services LLC	1002152	Agent - Health		5/14/2019
Inactive	Patriot Growth Insurance Services LLC	1002152	Agent - Life		5/14/2019