DEPARTMENT OF INSURANCE

Affiliations

Name	Douglas, Clarissa Dale	DOIID	700592	NAIC NPN	13236160

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Limited Line Credit	7/19/2013	4/30/2023
Pending Replacement	Resident	Agent	Property	10/25/2023		4/30/2025
Pending Replacement	Resident	Agent	Casualty	10/25/2023		4/30/2025
Pending Replacement CE Compliance	Resident	Agent	Health	7/10/2023
Pending Replacement CE Compliance	Resident	Agent	Life	7/10/2023
* 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	02/15/2025	04/30/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Pending Replacement	Aetna Health Inc. (PA)	660717	Agent - Health	12/8/2023
Pending Replacement	Aetna Health of Ohio Inc.	1065035	Agent - Health	12/8/2023
Pending Replacement	Aetna Life Insurance Company	301140	Agent - Health	12/8/2023
Inactive	Allstate Indemnity Company	300778	Agent - Casualty	10/30/2023	11/23/2023
Inactive	Allstate Indemnity Company	300778	Agent - Property	10/30/2023	11/23/2023
Inactive	Allstate Insurance Company	300773	Agent - Casualty	10/30/2023	11/23/2023
Inactive	Allstate Insurance Company	300773	Agent - Property	10/30/2023	11/23/2023
Inactive	Allstate Property and Casualty Insurance Company	300593	Agent - Casualty	10/30/2023	11/23/2023
Inactive	Allstate Property and Casualty Insurance Company	300593	Agent - Property	10/30/2023	11/23/2023
Inactive	Allstate Vehicle & Property Insurance Company	301429	Agent - Casualty	10/30/2023	11/23/2023
Inactive	Allstate Vehicle & Property Insurance Company	301429	Agent - Property	10/30/2023	11/23/2023
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	10/25/2023	4/13/2024
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	10/25/2023	4/13/2024
Inactive	American Health and Life Insurance Company	300844	Agent - Limited Line Credit	3/5/2009	5/4/2010
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	12/13/2023	12/12/2024
Inactive	Golden Rule Insurance Company	301943	Agent - Health	8/14/2023	5/2/2025
Inactive	Golden Rule Insurance Company	301943	Agent - Life	8/14/2023	5/2/2025
Inactive	Lincoln Heritage Life Insurance Company	500016	Agent - Health	11/28/2023	5/14/2024
Inactive	Lincoln Heritage Life Insurance Company	500016	Agent - Life	11/28/2023	5/14/2024
Inactive	Lyndon Southern Insurance Company	609602	Agent - Limited Line Credit	8/16/2013	4/30/2023
Pending Replacement	Philadelphia American Life Insurance Company	300178	Agent - Health	8/2/2023
Pending Replacement	Philadelphia American Life Insurance Company	300178	Agent - Life	8/2/2023
Pending Replacement	SilverScript Insurance Company	663526	Agent - Health	12/8/2023
Inactive	Southern Financial Life Insurance Company	300664	Agent - Health	7/6/2017	4/30/2023
Inactive	Southern Financial Life Insurance Company	300664	Agent - Life	7/6/2017	4/30/2023
Inactive	Southern Financial Life Insurance Company	300664	Agent - Limited Line Credit	8/16/2013	4/30/2023
Inactive	Triton Insurance Company	300654	Agent - Limited Line Credit	3/5/2009	5/4/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Eagle Financial Services Inc	401081	Agent - Limited Line Credit	3/1/2017	3/31/2022