DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Lisa M	DOIID	381607	NAIC NPN	1487828

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	12/29/2008		9/30/2026
Active	Resident	Agent	Life	12/29/2008		9/30/2026
Inactive	Resident	Agent	Health Maintenance Organization	4/29/1994	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	Allianz Life Insurance Company of North America	301791	Agent - Health	3/10/1995	3/23/2004
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	3/10/1995	3/23/2004
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	9/17/2013	3/14/2019
Inactive	CompBenefits Insurance Company	301864	Agent - Health	10/25/2019	1/7/2025
Inactive	Continental General Insurance Company	300691	Agent - Health	8/9/2018	1/25/2019
Inactive	Continental General Insurance Company	300691	Agent - Life	8/9/2018	1/25/2019
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	10/31/2013	1/7/2025
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	12/15/2014	1/7/2025
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/4/2018	1/7/2025
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health Maintenance Organization	4/29/1994	3/1/2001
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	1/13/2009	1/7/2025
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	12/30/1997	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	1/13/2009	1/7/2025
Inactive	Humana Insurance Company	301104	Agent - Life	1/13/2009	1/7/2025
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/31/2013	1/7/2025
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	12/15/2014	1/7/2025
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	12/21/2016	1/7/2025
Inactive	Kanawha Insurance Company	300127	Agent - Health	1/13/2009	8/9/2018
Inactive	Kanawha Insurance Company	300127	Agent - Life	1/13/2009	8/9/2018
Inactive	Union Security Insurance Company	301844	Agent - Health	11/9/1993	3/31/1997
Inactive	Union Security Insurance Company	301844	Agent - Life	11/9/1993	3/31/1997

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Humana MarketPOINT Inc.	398092	Agent - Life	2/1/2008	9/30/2008
Inactive	Humana MarketPOINT Inc.	398092	Agent - Health	2/1/2008	9/30/2008