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DEPARTMENT OF INSURANCE
Affiliations
Name
Clark, Elliott
DOIID
827485
NAIC NPN
17115303
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Active
Resident
Agent
Variable Life and Variable Annuities
6/2/2014
5/31/2025
Active
Resident
Agent
Health
12/12/2013
5/31/2025
Active
Resident
Agent
Life
11/21/2013
5/31/2025
* 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.
License Renewal Information
Class
Invoice Date
Response Due / Expiration Date
Response Received Date
Payment Received Date
Renewal Complete
Agent
03/15/2025
05/31/2025
Appointments with the following Insurers
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Active
American General Life Insurance Company
301585
Agent - Health
12/2/2019
Active
American General Life Insurance Company
301585
Agent - Life
1/7/2019
Active
American General Life Insurance Company
301585
Agent - Variable Life and Variable Annuities
1/7/2019
Active
Ameritas Life Insurance Corporation
300126
Agent - Health
2/1/2022
Inactive
Athene Annuity and Life Company
301893
Agent - Life
9/24/2020
1/19/2022
Inactive
Banner Life Insurance Company
301696
Agent - Life
10/29/2019
5/28/2024
Inactive
Brighthouse Life Insurance Company
301829
Agent - Health
2/23/2018
10/8/2024
Inactive
Brighthouse Life Insurance Company
301829
Agent - Life
2/23/2018
10/8/2024
Inactive
Brighthouse Life Insurance Company
301829
Agent - Variable Life and Variable Annuities
2/23/2018
10/8/2024
Active
CMFG Life Insurance Company
300929
Agent - Health
2/8/2019
Active
CMFG Life Insurance Company
300929
Agent - Life
2/8/2019
Active
CMFG Life Insurance Company
300929
Agent - Variable Life and Variable Annuities
2/8/2019
Active
Cincinnati Life Insurance Company (The)
300601
Agent - Life
1/16/2020
Inactive
Delaware Life Insurance Company
301256
Agent - Life
6/5/2019
4/12/2021
Inactive
Delaware Life Insurance Company
301256
Agent - Variable Life and Variable Annuities
6/5/2019
4/12/2021
Inactive
Equitable Financial Life Insurance Company
300808
Agent - Variable Life and Variable Annuities
2/28/2019
5/4/2021
Active
Forethought Life Insurance Company
301407
Agent - Health
7/3/2018
Active
Forethought Life Insurance Company
301407
Agent - Life
7/3/2018
Active
Forethought Life Insurance Company
301407
Agent - Variable Life and Variable Annuities
7/3/2018
Inactive
Fortitude Life Insurance & Annuity Company
301503
Agent - Life
8/21/2018
12/24/2018
Inactive
Fortitude Life Insurance & Annuity Company
301503
Agent - Variable Life and Variable Annuities
8/21/2018
12/24/2018
Active
Integrity Life Insurance Company
301687
Agent - Life
9/3/2021
Active
Integrity Life Insurance Company
301687
Agent - Variable Life and Variable Annuities
9/3/2021
Inactive
Jackson National Life Insurance Company
300486
Agent - Life
10/21/2015
1/9/2024
Inactive
Jackson National Life Insurance Company
300486
Agent - Variable Life and Variable Annuities
10/21/2015
1/9/2024
Inactive
Lincoln Life Assurance Company of Boston
301915
Agent - Life
10/19/2015
10/10/2019
Inactive
Lincoln National Life Insurance Company (The)
301382
Agent - Health
10/7/2015
11/22/2024
Inactive
Lincoln National Life Insurance Company (The)
301382
Agent - Life
10/7/2015
11/22/2024
Inactive
Lincoln National Life Insurance Company (The)
301382
Agent - Variable Life and Variable Annuities
10/7/2015
11/22/2024
Active
MEMBERS Life Insurance Company
301289
Agent - Health
2/8/2019
Active
MEMBERS Life Insurance Company
301289
Agent - Life
2/8/2019
Active
MEMBERS Life Insurance Company
301289
Agent - Variable Life and Variable Annuities
2/8/2019
Active
MassMutual Ascend Life Insurance Company
300320
Agent - Life
9/14/2018
Active
MassMutual Ascend Life Insurance Company
300320
Agent - Variable Life and Variable Annuities
4/7/2021
Active
Massachusetts Mutual Life Insurance Company
300445
Agent - Life
5/15/2024
Inactive
Midland National Life Insurance Company
300923
Agent - Life
6/26/2020
4/14/2021
Inactive
Midland National Life Insurance Company
300923
Agent - Variable Life and Variable Annuities
6/26/2020
4/14/2021
Inactive
Nationwide Life Insurance Company
300495
Agent - Health
3/29/2018
12/17/2020
Inactive
Nationwide Life Insurance Company
300495
Agent - Life
3/29/2018
12/17/2020
Inactive
Nationwide Life Insurance Company
300495
Agent - Variable Life and Variable Annuities
3/29/2018
12/17/2020
Inactive
Nationwide Life and Annuity Insurance Company
300714
Agent - Health
5/10/2018
12/17/2020
Inactive
Nationwide Life and Annuity Insurance Company
300714
Agent - Life
5/10/2018
12/17/2020
Inactive
Nationwide Life and Annuity Insurance Company
300714
Agent - Variable Life and Variable Annuities
5/10/2018
12/17/2020
Inactive
New York Life Insurance and Annuity Corporation
300726
Agent - Life
2/16/2018
4/8/2021
Active
Pacific Life Insurance Company
301848
Agent - Health
8/6/2021
Active
Pacific Life Insurance Company
301848
Agent - Life
8/6/2021
Active
Pacific Life Insurance Company
301848
Agent - Variable Life and Variable Annuities
8/6/2021
Active
Penn Insurance and Annuity Company
300712
Agent - Life
4/28/2022
Active
Penn Mutual Life Insurance Company
301394
Agent - Life
4/28/2022
Inactive
Pruco Life Insurance Company
300954
Agent - Life
4/13/2018
12/23/2024
Inactive
Pruco Life Insurance Company
300954
Agent - Variable Life and Variable Annuities
4/13/2018
12/23/2024
Active
S.USA Life Insurance Company, Inc.
301774
Agent - Life
4/23/2021
Active
State Life Insurance Company
301497
Agent - Health
10/6/2015
Inactive
State Life Insurance Company
301497
Agent - Life
10/6/2015
11/16/2023
Inactive
Symetra Life Insurance Company
301691
Agent - Health
2/20/2018
12/30/2024
Inactive
Symetra Life Insurance Company
301691
Agent - Life
2/20/2018
12/30/2024
Inactive
Symetra Life Insurance Company
301691
Agent - Variable Life and Variable Annuities
2/20/2018
12/30/2024
Active
Transamerica Life Insurance Company
300571
Agent - Life
10/19/2015
Active
Transamerica Life Insurance Company
300571
Agent - Variable Life and Variable Annuities
10/19/2015
Active
Western-Southern Life Assurance Company
301590
Agent - Health
9/3/2021
Active
Western-Southern Life Assurance Company
301590
Agent - Life
9/3/2021
Designated to act on behalf of the following Business Entities
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Fifth Third Insurance Agency Inc
399341
Agent - Life
6/19/2014
7/7/2015
Inactive
Fifth Third Insurance Agency Inc
399341
Agent - Health
6/10/2014
7/7/2015
Inactive
Fifth Third Insurance Agency Inc
399341
Agent - Variable Life and Variable Annuities
6/10/2014
7/7/2015
Inactive
Huntington Investment Co The
633475
Agent - Life
4/15/2020
4/16/2021
Inactive
Huntington Investment Co The
633475
Agent - Variable Life and Variable Annuities
4/15/2020
4/16/2021
Active
LPL FINANCIAL LLC
399327
Agent - Life
4/14/2021
Active
LPL FINANCIAL LLC
399327
Agent - Health
4/14/2021
Active
LPL FINANCIAL LLC
399327
Agent - Variable Life and Variable Annuities
4/14/2021
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