DEPARTMENT OF INSURANCE
Affiliations
NameClark, David MDOIID510339NAIC NPN783787
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentProperty10/13/201011/30/2014 
InactiveNon ResidentAgentLife10/13/201011/30/2014 
InactiveNon ResidentAgentCasualty10/13/201011/30/2014 
InactiveNon ResidentAgentVariable Life and Variable Annuities5/31/20019/29/2008 
InactiveNon ResidentAgentHealth10/13/201011/30/2014 
* 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
InactiveAnthem Life Insurance Company301209Agent - Health11/1/201311/30/2014
InactiveAnthem Life Insurance Company301209Agent - Life11/1/201311/30/2014
InactiveBanner Life Insurance Company301696Agent - Life7/9/201311/30/2014
InactiveCompBenefits Dental, Inc.591692Agent - Health9/30/201311/30/2014
InactiveDental Concern Inc. (The)301641Agent - Health9/30/201311/30/2014
InactiveGateway Health Plan of Ohio, Inc.833424Agent - Health10/7/201411/30/2014
InactiveHumana Benefit Plan of Illinois, Inc.781543Agent - Health10/13/201411/30/2014
InactiveHumana Health Plan of Ohio Inc.301565Agent - Health9/30/201311/30/2014
InactiveHumana Health Plan, Inc.300142Agent - Health9/30/201311/30/2014
InactiveHumana Insurance Company301104Agent - Health9/30/201311/30/2014
InactiveHumana Insurance Company301104Agent - Life9/30/201311/30/2014
InactiveHumana Insurance Company of Kentucky300826Agent - Health9/30/201311/30/2014
InactiveHumana Insurance Company of Kentucky300826Agent - Life9/30/201311/30/2014
InactiveHumana Medical Plan, Inc.801568Agent - Health10/13/201411/30/2014
InactiveKanawha Insurance Company300127Agent - Health9/30/201311/30/2014
InactiveKanawha Insurance Company300127Agent - Life9/30/201311/30/2014
InactivePacifiCare Life and Health Insurance Company301304Agent - Health11/1/20103/31/2011
InactiveRiverSource Life Insurance Company301952Agent - Health6/19/20003/4/2003
InactiveRiverSource Life Insurance Company301952Agent - Life6/19/20003/4/2003
InactiveRiverSource Life Insurance Company301952Agent - Variable Life and Variable Annuities3/8/20013/4/2003
InactiveTalcott Resolution Life Insurance Company301759Agent - Health10/26/200111/24/2007
InactiveTalcott Resolution Life Insurance Company301759Agent - Life10/26/200111/24/2007
InactiveTalcott Resolution Life Insurance Company301759Agent - Variable Life and Variable Annuities10/26/200111/24/2007
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Health10/26/200111/24/2007
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Life10/26/200111/24/2007
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Variable Life and Variable Annuities10/26/200111/24/2007
InactiveUnion Security Insurance Company301844Agent - Life7/23/20013/27/2003
InactiveUnion Security Insurance Company301844Agent - Variable Life and Variable Annuities7/23/20013/27/2003
InactiveUnitedHealthcare Insurance Company300946Agent - Health11/1/20103/31/2011
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health11/1/20103/31/2011
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveDesignated Agent Company Inc.681257Agent - Life11/1/201311/30/2014
InactiveDesignated Agent Company Inc.681257Agent - Health11/1/201311/30/2014

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