DEPARTMENT OF INSURANCE

Name	Willoughby, David	DOIID	362988	NAIC NPN	7197185

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	5/16/1994	7/1/2004
Inactive	Resident	Agent	Life	4/7/1994	7/1/2004
Inactive	Resident	Agent	Health Maintenance Organization	4/25/1997	3/1/2001

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

No License Renewal Information

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date. Licensees subject to CE must complete CE requirements before Next Compliance Date in order to successfully complete the License Renewal Process.

Address Information

Type	Address
Residence	Not Public Information
Business / Home Office	3037 Estes Court Mount Sterling, KY 40353

Phone Information

Type	Phone
Business / Home Office	(859) 293-5601