DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Erickson, Thomas J	DOIID	365536	NAIC NPN	289656

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	4/6/1994	2/18/2002
Inactive	Non Resident	Agent	Life	4/6/1994	2/19/2002
* 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	Nationwide Life Insurance Company	300495	Agent - Health	4/6/1994	2/18/2002
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	4/6/1994	2/19/2002

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Wausau Signature Agency, LLC	399369	Agent - Life	4/12/1994	2/19/2002
Inactive	Wausau Signature Agency, LLC	399369	Agent - Health	4/12/1994	2/19/2002