Individual Information

DOUGLAS EDWARD BROADBENT

BOULDER CITY, NV 89005

Active

douglas.broadbent@american-national.com

02/22/1984

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Res. Producer/Producer Firm	14777	10/01/2001	Active	10/01/2001	02/28/2025

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	10/01/2001	Active	10/01/2001
Health	10/01/2001	Active	10/01/2001
Life	10/01/2001	Active	10/01/2001
Property	10/01/2001	Active	10/01/2001
Var. Annuities/Var. Life	10/01/2001	Active	10/01/2001
Casualty	02/22/1984	Inactive	10/01/2001
Health	02/22/1984	Inactive	10/01/2001
Life	02/22/1984	Inactive	10/01/2001
Property	02/22/1984	Inactive	10/01/2001
Surety	07/30/2002	Inactive	01/01/2020
Var. Annuities/Var. Life	02/07/1992	Inactive	10/01/2001

Company Name	Appointment Type	Status	Active Date
1795
AMERICAN MODERN PROPERTY AND CASUALTY INSURANCE COMPANY	Casualty	Active	06/12/2018
	Property	Active	06/12/2018
283
Company Name	Appointment Type	Status	Active Date
BANNER LIFE INSURANCE COMPANY	Life	Active	05/05/2023
10708
Company Name	Appointment Type	Status	Active Date
ILLINOIS MUTUAL LIFE INSURANCE COMPANY	Health	Active	02/09/2009
	Life	Active	02/09/2009
378
Company Name	Appointment Type	Status	Active Date
LINCOLN NATIONAL LIFE INSURANCE COMPANY	Health	Active	06/26/2023
	Life	Active	06/26/2023
	Var. Annuities/Var. Life	Active	06/26/2023
103
Company Name	Appointment Type	Status	Active Date
PRINCIPAL LIFE INSURANCE COMPANY	Health	Active	11/12/2007
	Life	Active	11/12/2007
890
Company Name	Appointment Type	Status	Active Date
TRANSAMERICA LIFE INSURANCE COMPANY	Life	Active	05/24/2012
	Var. Annuities/Var. Life	Active	05/24/2012

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