DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Petersen, Daurine Renee	DOIID	558268	NAIC NPN	7376637

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	12/9/2002	10/31/2006
Inactive	Non Resident	Agent	Health	12/9/2002	10/31/2006
* 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	Minnesota Life Insurance Company	300488	Agent - Health	4/30/2003	7/3/2006
Inactive	Minnesota Life Insurance Company	300488	Agent - Life	4/30/2003	7/3/2006
Inactive	Stonebridge Life Insurance Company	301614	Agent - Health	12/9/2002	10/28/2004
Inactive	Stonebridge Life Insurance Company	301614	Agent - Life	12/9/2002	10/28/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Financial Insurance Services, Inc.	514710	Agent - Health	2/27/2004	7/3/2006
Inactive	Financial Insurance Services, Inc.	514710	Agent - Life	2/27/2004	7/3/2006