DEPARTMENT OF INSURANCE
Affiliations
NameClark, Carletta DanielleDOIID1033561NAIC NPN17315338
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentVariable Life and Variable Annuities3/21/20192/28/2023 
InactiveNon ResidentAgentHealth3/21/20192/28/2023 
InactiveNon ResidentAgentLife3/21/20192/28/2023 
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAllianz Life Insurance Company of North America301791Agent - Life4/3/201910/19/2021
InactiveAllianz Life Insurance Company of North America301791Agent - Variable Life and Variable Annuities4/3/201910/4/2021
InactiveBrighthouse Life Insurance Company301829Agent - Life4/4/20192/28/2023
InactiveBrighthouse Life Insurance Company301829Agent - Variable Life and Variable Annuities4/4/20192/28/2023
InactiveEquitable Financial Life Insurance Company of America301772Agent - Life5/21/20223/22/2023
InactiveEquitable Financial Life Insurance Company of America301772Agent - Variable Life and Variable Annuities5/21/20223/22/2023
InactiveJackson National Life Insurance Company300486Agent - Life4/8/20193/16/2022
InactiveJackson National Life Insurance Company300486Agent - Variable Life and Variable Annuities4/8/20193/16/2022
InactiveNationwide Life Insurance Company300495Agent - Health2/23/20212/28/2023
InactiveNationwide Life Insurance Company300495Agent - Life2/23/20212/28/2023
InactiveNationwide Life Insurance Company300495Agent - Variable Life and Variable Annuities2/23/20212/28/2023
InactiveNationwide Life and Annuity Insurance Company300714Agent - Health2/23/20212/28/2023
InactiveNationwide Life and Annuity Insurance Company300714Agent - Life2/23/20212/28/2023
InactiveNationwide Life and Annuity Insurance Company300714Agent - Variable Life and Variable Annuities2/23/20212/28/2023
InactivePacific Life Insurance Company301848Agent - Health4/5/201911/22/2022
InactivePacific Life Insurance Company301848Agent - Life4/5/201911/22/2022
InactivePacific Life Insurance Company301848Agent - Variable Life and Variable Annuities4/5/201911/22/2022
InactiveTransamerica Life Insurance Company300571Agent - Life4/4/20192/28/2023
InactiveTransamerica Life Insurance Company300571Agent - Variable Life and Variable Annuities4/4/20192/28/2023
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveChase Insurance Agency, Inc.398324Agent - Life6/13/20195/24/2021
InactiveChase Insurance Agency, Inc.398324Agent - Health6/13/20195/24/2021
InactiveChase Insurance Agency, Inc.398324Agent - Variable Life and Variable Annuities6/13/20195/24/2021

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