DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Kristin Clark Insurance Inc.	DOIID	509495	NAIC NPN	7223123

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Casualty	8/15/2000		3/31/2028
Active	Resident	Agent	Life	6/2/2000		3/31/2028
Active	Resident	Agent	Property	8/15/2000		3/31/2028
Active	Resident	Agent	Health	6/2/2000		3/31/2028
Inactive	Resident	Agent	General Lines	6/2/2000	8/15/2000
* 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 Health Plans of Kentucky, Inc.	300999	Agent - Health	9/1/2005
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	6/12/2021
Active	FB Insurance Company (The)	301763	Agent - Casualty	8/15/2000
Inactive	FB Insurance Company (The)	301763	Agent - General Lines	6/2/2000	8/15/2000
Active	FB Insurance Company (The)	301763	Agent - Property	8/15/2000
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	8/15/2000
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - General Lines	6/2/2000	8/15/2000
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	8/15/2000
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	6/2/2000
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	6/2/2000

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Clark, Kristin Conley	324567	Agent - Casualty	3/31/2003
Inactive	Clark, Kristin Conley	324567	Agent - General Lines	6/2/2000	8/15/2000
Active	Clark, Kristin Conley	324567	Agent - Health	3/31/2003
Active	Clark, Kristin Conley	324567	Agent - Life	3/31/2003
Active	Clark, Kristin Conley	324567	Agent - Property	3/31/2003