DEPARTMENT OF INSURANCE

Affiliations

Name	Bruner, Terri A	DOIID	505529	NAIC NPN	7211980

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Administrator	Not Applicable	12/21/1999	4/8/2021
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Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Specialty Benefits, Inc.	505530	Administrator - Not Applicable	12/21/1999	4/8/2021