DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Shelbie	DOIID	1017122	NAIC NPN	18956531

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/29/2018	6/30/2021
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	TZ Insurance Solutions LLC	727470	Agent - Health