DEPARTMENT OF INSURANCE

Name	Clark, Michael	DOIID	1055016	NAIC NPN	6592793

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	9/6/2019	9/30/2027
Active	Non Resident	Agent	Casualty	11/19/2020	9/30/2027
Active	Non Resident	Agent	Health	9/6/2019	9/30/2027
Active	Non Resident	Agent	Property	11/19/2020	9/30/2027

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

No License Renewal Information

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date. Licensees subject to CE must complete CE requirements before Next Compliance Date in order to successfully complete the License Renewal Process.

Address Information

Type	Address
Residence	Not Public Information
Business / Home Office	135 Vermillion Loop Statesville, NC 286252747

Internet Information

Type	Address
Business Email	mtclark1@outlook.com

Phone Information

Type	Phone
Business / Home Office	(704) 677-9831