DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Keith B	DOIID	1338645	NAIC NPN	20842490

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	5/3/2024		3/31/2026
* 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
Active	Anthem Life Insurance Company	301209	Agent - Life	9/17/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	World Financial Group Insurance Agency, LLC	400520	Agent - Life	1/3/2025