DEPARTMENT OF INSURANCE

Affiliations

Name	Mize, Carroll Richard	DOIID	376531	NAIC NPN	1467541

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	10/16/2024		7/31/2026
Active	Resident	Agent	Casualty	10/16/2024		7/31/2026
Active	Resident	Agent	Life	10/16/2024		7/31/2026
Inactive	Resident	Agent	Property	7/5/2019	7/31/2024
Inactive	Resident	Agent	General Lines	1/13/1995	8/15/2000
Inactive	Resident	Agent	Health Maintenance Organization	2/25/1997	3/1/2001
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aetna Health Inc.	300694	Agent - Health	3/1/2001	10/24/2002
Inactive	Aetna Health Inc.	300694	Agent - Health Maintenance Organization	2/25/1997	3/1/2001
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	2/5/2001	11/21/2007
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	2/5/2001	11/21/2007
Inactive	AmTrust Insurance Company	300179	Agent - Casualty	8/15/2000	7/31/2008
Inactive	AmTrust Insurance Company	300179	Agent - General Lines	10/23/1995	8/15/2000
Inactive	AmTrust Insurance Company	300179	Agent - Property	8/15/2000	7/31/2008
Inactive	American Equity Investment Life Insurance Company	300389	Agent - Life	12/11/2000	7/31/2008
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	3/9/2018	8/6/2018
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	3/9/2018	8/6/2018
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	2/24/2006	7/31/2008
Inactive	American Fire and Casualty Company	300567	Agent - Property	2/24/2006	7/31/2008
Inactive	Centennial Life Insurance Company (The)	301561	Agent - Health	1/18/1996	3/31/1997
Inactive	Centennial Life Insurance Company (The)	301561	Agent - Life	1/18/1996	3/31/1997
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	9/8/2007	7/31/2008
Inactive	Consolidated Insurance Company	300943	Agent - Property	9/8/2007	7/31/2008
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	9/8/2010
Inactive	Emphesys Insurance Company	300598	Agent - Health	5/12/1994	3/31/1997
Inactive	Emphesys Insurance Company	300598	Agent - Life	5/12/1994	3/31/1997
Inactive	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	1/2/2002	10/17/2005
Inactive	First Colony Life Insurance Company	301179	Agent - Life	10/17/1995	7/14/2004
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Health	9/26/1995	10/28/1996
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Life	9/26/1995	10/28/1996
Inactive	Freedom Life Insurance Company of America	300074	Agent - Health	6/21/1994	3/31/1997
Inactive	Freedom Life Insurance Company of America	300074	Agent - Life	6/21/1994	3/31/1997
Inactive	Genworth Life Insurance Company	300623	Agent - Health	12/11/2001	12/4/2007
Inactive	Genworth Life Insurance Company	300623	Agent - Life	12/11/2001	12/4/2007
Inactive	Golden Rule Insurance Company	301943	Agent - Health	3/3/1995	11/12/1998
Inactive	Golden Rule Insurance Company	301943	Agent - Life	3/3/1995	11/12/1998
Inactive	Grange Indemnity Insurance Company	300793	Agent - Casualty	12/22/2016	7/31/2018
Inactive	Grange Indemnity Insurance Company	300793	Agent - Property	12/22/2016	7/31/2018
Inactive	Grange Insurance Company	300234	Agent - Casualty	12/22/2016	7/31/2018
Inactive	Grange Insurance Company	300234	Agent - General Lines	12/20/1996	8/15/2000
Inactive	Grange Insurance Company	300234	Agent - Property	12/22/2016	7/31/2018
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Casualty	12/22/2016	7/31/2018
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Property	12/22/2016	7/31/2018
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Casualty	1/23/2006	7/31/2008
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Property	1/23/2006	7/31/2008
Inactive	Hartford Casualty Insurance Company	301332	Agent - Casualty	1/23/2006	7/31/2008
Inactive	Hartford Casualty Insurance Company	301332	Agent - Property	1/23/2006	7/31/2008
Inactive	Hartford Fire Insurance Company	300628	Agent - Casualty	1/23/2006	7/31/2008
Inactive	Hartford Fire Insurance Company	300628	Agent - Property	1/23/2006	7/31/2008
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Casualty	1/23/2006	7/31/2008
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Property	1/23/2006	7/31/2008
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Casualty	1/23/2006	7/31/2008
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Property	1/23/2006	7/31/2008
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/15/2007	7/31/2008
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	7/14/1998	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	3/15/2007	7/31/2008
Inactive	Humana Insurance Company	301104	Agent - Life	3/15/2007	7/31/2008
Inactive	ING Insurance Company of America	301507	Agent - Life	3/5/1997	12/31/2002
Inactive	Indiana Insurance Company	301909	Agent - Casualty	9/8/2007	7/31/2008
Inactive	Indiana Insurance Company	301909	Agent - Property	9/8/2007	7/31/2008
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	1/12/2012	4/29/2014
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Health	6/8/1993	3/31/1997
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	6/8/1993	3/31/1997
Inactive	John Alden Life Insurance Company	300573	Agent - Health	12/15/2003	7/31/2008
Inactive	John Alden Life Insurance Company	300573	Agent - Life	12/15/2003	7/31/2008
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/10/2008	7/31/2008
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/10/2008	7/31/2008
Inactive	LifeUSA Insurance Company	300386	Agent - Health	6/20/1990	3/6/1996
Inactive	LifeUSA Insurance Company	300386	Agent - Life	6/20/1990	3/6/1996
Inactive	Manhattan National Life Insurance Company	301011	Agent - Health	10/27/1995	3/31/1997
Inactive	Manhattan National Life Insurance Company	301011	Agent - Life	10/27/1995	3/31/1997
Inactive	Meridian Mutual Insurance Company	301303	Agent - Casualty	8/15/2000	6/1/2001
Inactive	Meridian Mutual Insurance Company	301303	Agent - General Lines	1/13/1995	8/15/2000
Inactive	Meridian Mutual Insurance Company	301303	Agent - Property	8/15/2000	6/1/2001
Inactive	Midland National Life Insurance Company	300923	Agent - Health	4/17/1995	3/31/1997
Inactive	Midland National Life Insurance Company	300923	Agent - Life	4/17/1995	3/31/1997
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	9/8/2007	7/31/2008
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	9/8/2007	7/31/2008
Inactive	Northern Life Insurance Company	300301	Agent - Health	9/6/1995	6/5/1998
Inactive	Northern Life Insurance Company	300301	Agent - Life	9/6/1995	6/5/1998
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	2/24/2006	7/31/2008
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	2/24/2006	7/31/2008
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	2/24/2006	7/31/2008
Inactive	Ohio Security Insurance Company	300622	Agent - Property	2/24/2006	7/31/2008
Inactive	Ohio State Life Insurance Company (The)	300865	Agent - Life	5/15/1992	3/31/1997
Inactive	Omaha Insurance Company	751908	Agent - Health	9/29/2014	8/24/2015
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	11/2/2005	7/31/2008
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Life	11/2/2005	7/31/2008
Inactive	Pacific Life Insurance Company	301848	Agent - Life	7/15/1999	5/27/2003
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	9/8/2007	7/31/2008
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	9/8/2007	7/31/2008
Inactive	Peerless Insurance Company	301910	Agent - Casualty	9/8/2007	7/31/2008
Inactive	Peerless Insurance Company	301910	Agent - Property	9/8/2007	7/31/2008
Inactive	Peoples Benefit Life Insurance Company	301895	Agent - Life	7/18/2001	10/1/2007
Inactive	Pioneer Life Insurance Company	300110	Agent - Health	4/7/1995	8/25/2003
Inactive	Pioneer Life Insurance Company	300110	Agent - Life	4/7/1995	8/25/2003
Inactive	Security National Insurance Company	301151	Agent - Casualty	8/15/2000	7/31/2008
Inactive	Security National Insurance Company	301151	Agent - General Lines	10/23/1995	8/15/2000
Inactive	Security National Insurance Company	301151	Agent - Property	8/15/2000	7/31/2008
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Casualty	1/23/2006	7/31/2008
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Property	1/23/2006	7/31/2008
Inactive	Standard Life Insurance Company of Indiana	300116	Agent - Health	3/8/2002	7/31/2008
Inactive	Standard Life Insurance Company of Indiana	300116	Agent - Life	3/8/2002	7/31/2008
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Casualty	6/1/2001	1/2/2002
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Property	6/1/2001	1/2/2002
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Health	2/24/1997	7/31/2008
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	2/24/1997	7/31/2008
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Health	2/24/1997	7/31/2008
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Life	2/24/1997	7/31/2008
Inactive	Time Insurance Company	300683	Agent - Health	9/4/2001	7/31/2008
Inactive	Time Insurance Company	300683	Agent - Life	9/4/2001	7/31/2008
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	10/1/2005	7/31/2008
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	10/1/2005	7/31/2008
Inactive	Transamerica Life Insurance and Annuity Company	300148	Agent - Health	1/11/2002	10/1/2005
Inactive	Transamerica Life Insurance and Annuity Company	300148	Agent - Life	1/11/2002	10/1/2005
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Health	1/11/2002	7/31/2008
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Life	1/11/2002	7/31/2008
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	10/1/2007	7/31/2008
Inactive	Trinity Universal Insurance Company	300911	Agent - Casualty	8/15/2000	7/31/2008
Inactive	Trinity Universal Insurance Company	300911	Agent - General Lines	10/23/1995	8/15/2000
Inactive	Trinity Universal Insurance Company	300911	Agent - Property	8/15/2000	7/31/2008
Inactive	Trustgard Insurance Company	300104	Agent - Casualty	12/22/2016	7/31/2018
Inactive	Trustgard Insurance Company	300104	Agent - Property	12/22/2016	7/31/2018
Inactive	Twin City Fire Insurance Company	300721	Agent - Casualty	1/23/2006	7/31/2008
Inactive	Twin City Fire Insurance Company	300721	Agent - Property	1/23/2006	7/31/2008
Inactive	Union Security Insurance Company	301844	Agent - Health	3/9/1995	7/31/2008
Inactive	Union Security Insurance Company	301844	Agent - Life	3/9/1995	7/31/2008
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	2/22/1993	3/31/1997
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	2/22/1993	3/31/1997
Inactive	Voya Retirement Insurance and Annuity Company	300643	Agent - Health	3/5/1997	12/1/2006
Inactive	Voya Retirement Insurance and Annuity Company	300643	Agent - Life	3/5/1997	12/1/2006
Inactive	West American Insurance Company	301112	Agent - Casualty	2/24/2006	7/31/2008
Inactive	West American Insurance Company	301112	Agent - Property	2/24/2006	7/31/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	6/8/2000	5/10/2001
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	6/8/2000	5/10/2001
Inactive	Healthplan Services, Inc.	401230	Agent - Health	8/31/1995	3/31/1997
Inactive	Medlink Inc	400721	Agent - Life	5/16/2002	7/31/2008
Inactive	Medlink Inc	400721	Agent - Health	5/16/2002	7/31/2008
Inactive	World Marketing Alliance Inc.	398156	Agent - Life	2/5/1999	3/21/2003
Inactive	World Marketing Alliance Inc.	398156	Agent - Health	2/5/1999	3/21/2003