DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Glasheen, Miriam Clare	DOIID	517587	NAIC NPN	2489252

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	11/8/2000	3/31/2005
Inactive	Non Resident	Agent	Health	11/8/2001	3/31/2005
* 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	Amica Life Insurance Company	301676	Agent - Life	11/8/2000	10/29/2004
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	11/8/2001	3/31/2005
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	11/8/2001	3/31/2005
Inactive	John Hancock Variable Life Insurance Company	301914	Agent - Health	11/8/2001	3/31/2005
Inactive	John Hancock Variable Life Insurance Company	301914	Agent - Life	11/8/2001	3/31/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Amica General Agency, LLC	509383	Agent - Life	3/11/2002	6/23/2003
Inactive	Amica General Agency, LLC	509383	Agent - Health	3/11/2002	6/23/2003