DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Beverly Jane	DOIID	304475	NAIC NPN	1486702

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	4/21/1993	3/31/2020
Inactive	Resident	Agent	Health	4/21/1993	3/31/2020
Inactive	Resident	Agent	Health Maintenance Organization	2/8/1993	3/1/2001
* 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
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	7/6/2011	9/30/2012
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	7/6/2011	9/30/2012
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	3/1/2001	5/10/2017
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health Maintenance Organization	2/8/1993	3/1/2001
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	5/13/1998	10/10/2012
Inactive	Anthem Life Insurance Company	301209	Agent - Health	4/21/1993	5/10/2017
Inactive	Anthem Life Insurance Company	301209	Agent - Life	4/21/1993	5/10/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Acordia of Louisville Inc.	401252	Agent - Health	5/16/1994	5/31/2003
Inactive	Acordia of Louisville Inc.	401252	Agent - Life	5/16/1994	5/31/2003
Inactive	Ahead, Inc	549477	Agent - Health	3/13/2009	2/14/2020
Inactive	Ahead, Inc	549477	Agent - Life	3/17/2009	2/14/2020
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	4/15/2004	6/21/2008
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	4/15/2004	6/21/2008