DEPARTMENT OF INSURANCE

Affiliations

Name	Clark III, William C	DOIID	676888	NAIC NPN	10486627

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Property	12/27/2012	9/30/2024
Active	Resident	Agent	Casualty	12/27/2012	9/30/2024
Active	Resident	Agent	Health	12/27/2012	9/30/2024
Active	Resident	Agent	Life	12/27/2012	9/30/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	07/15/2024	09/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Anthem Life Insurance Company	301209	Agent - Health	3/15/2013
Active	Anthem Life Insurance Company	301209	Agent - Life	3/15/2013
Active	Bristol West Insurance Company	301655	Agent - Casualty	1/11/2013
Active	Bristol West Insurance Company	301655	Agent - Property	1/11/2013
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	9/10/2013	12/5/2014
Active	Dairyland Insurance Company	301370	Agent - Casualty	9/26/2016
Active	Dairyland Insurance Company	301370	Agent - Property	9/26/2016
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/10/2013	12/5/2014
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	1/11/2013
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	1/11/2013
Inactive	Golden Rule Insurance Company	301943	Agent - Health	8/24/2009	10/1/2012
Inactive	Golden Rule Insurance Company	301943	Agent - Life	8/24/2009	10/1/2012
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/10/2013	12/5/2014
Inactive	Humana Insurance Company	301104	Agent - Health	9/20/2013	4/13/2015
Inactive	Humana Insurance Company	301104	Agent - Life	9/20/2013	4/13/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/10/2013	12/5/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/10/2013	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/10/2013	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	9/10/2013	12/5/2014
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	1/18/2013	1/24/2013
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	1/18/2013	1/24/2013
Active	Shelter General Insurance Company	301109	Agent - Casualty	12/31/2012
Active	Shelter General Insurance Company	301109	Agent - Property	12/31/2012
Active	Shelter Life Insurance Company	300391	Agent - Health	12/31/2012
Active	Shelter Life Insurance Company	300391	Agent - Life	12/31/2012
Active	Shelter Mutual Insurance Company	301870	Agent - Casualty	12/31/2012
Active	Shelter Mutual Insurance Company	301870	Agent - Property	12/31/2012
Inactive	Time Insurance Company	300683	Agent - Health	2/10/2015	11/22/2019
Inactive	Time Insurance Company	300683	Agent - Life	2/10/2015	11/22/2019
Inactive	United Financial Casualty Company	301886	Agent - Casualty	1/18/2013	1/24/2013
Inactive	United Financial Casualty Company	301886	Agent - Property	1/18/2013	1/24/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Daniel Boone Agency, LLC.	515760	Agent - Property	1/14/2013
Active	Daniel Boone Agency, LLC.	515760	Agent - Casualty	1/14/2013
Active	Daniel Boone Agency, LLC.	515760	Agent - Life	1/14/2013
Active	Daniel Boone Agency, LLC.	515760	Agent - Health	1/14/2013
Active	Designated Agent Company Inc.	681257	Agent - Life	3/30/2013
Active	Designated Agent Company Inc.	681257	Agent - Health	3/30/2013
Active	Gateway Ins Marketing Inc	613567	Agent - Life	1/18/2013
Active	Gateway Ins Marketing Inc	613567	Agent - Health	1/18/2013
Inactive	Medlink Inc	400721	Agent - Life	8/24/2010	10/1/2012
Inactive	Medlink Inc	400721	Agent - Health	8/24/2010	10/1/2012