DEPARTMENT OF INSURANCE

Affiliations

Name	Mercker, Theresa O'bryan	DOIID	378811	NAIC NPN	735609

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	General Lines	1/7/1998	9/21/1998
Inactive	Resident	Agent	Life	10/31/1996	3/31/2004
Inactive	Resident	Agent	Health	10/31/1996	3/31/2004
Inactive	Resident	Temporary Agent	Ordinary Life (Temporary Life)	10/9/1996	10/31/1996
* 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	C.M. Life Insurance Company	301335	Agent - Health	12/30/1996	4/17/1997
Inactive	C.M. Life Insurance Company	301335	Agent - Life	12/30/1996	4/17/1997
Inactive	Everlake Life Insurance Company	300873	Agent - Health	9/23/1998	4/30/1999
Inactive	Everlake Life Insurance Company	300873	Agent - Life	9/23/1998	4/30/1999
Inactive	LM General Insurance Company	300133	Agent - General Lines	1/7/1998	9/21/1998
Inactive	LM Property and Casualty Insurance Company	301658	Agent - General Lines	1/7/1998	9/21/1998
Inactive	Lincoln Benefit Life Company	301110	Agent - Health	10/20/1998	8/20/2001
Inactive	Lincoln Benefit Life Company	301110	Agent - Life	10/20/1998	8/20/2001
Inactive	MML Bay State Life Insurance Company	301198	Agent - Health	12/30/1996	4/17/1997
Inactive	MML Bay State Life Insurance Company	301198	Agent - Life	12/30/1996	4/17/1997
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Health	10/31/1996	4/17/1997
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Life	10/31/1996	4/17/1997
Inactive	Massachusetts Mutual Life Insurance Company	300445	Temporary Agent - Ordinary Life (Temporary Life)	10/9/1996	10/31/1996
Inactive	Paul Revere Life Insurance Company	300971	Agent - Health	11/2/1998	12/11/2002
Inactive	Paul Revere Life Insurance Company	300971	Agent - Life	11/2/1998	12/11/2002
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	11/2/1998	3/31/2004
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	11/2/1998	3/31/2004
Inactive	Pruco Life Insurance Company	300954	Agent - Health	4/14/1997	9/21/1998
Inactive	Pruco Life Insurance Company	300954	Agent - Life	4/14/1997	9/21/1998
Inactive	Prudential Insurance Company of America	300784	Agent - Health	4/14/1997	9/21/1998
Inactive	Prudential Insurance Company of America	300784	Agent - Life	4/14/1997	9/21/1998

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	West Kentucky Group Benefits	401049	Agent - Life	12/28/1998	2/24/2003
Inactive	West Kentucky Group Benefits	401049	Agent - Health	12/28/1998	2/24/2003