DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark Jr, George M	DOIID	954675	NAIC NPN	6649103

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	5/17/2017	9/30/2020
Inactive	Non Resident	Agent	Health	5/17/2017	9/30/2020
* 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
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	8/27/2018	9/30/2020
Inactive	Aetna Life Insurance Company	301140	Agent - Health	8/27/2018	9/30/2020
Inactive	Aetna Life Insurance Company	301140	Agent - Life	8/27/2018	9/30/2020
Inactive	American General Life Insurance Company	301585	Agent - Health	3/2/2018	9/30/2020
Inactive	American General Life Insurance Company	301585	Agent - Life	3/2/2018	9/30/2020
Inactive	Colorado Bankers Life Insurance Company	301845	Agent - Health	8/9/2017	7/18/2019
Inactive	Colorado Bankers Life Insurance Company	301845	Agent - Life	8/9/2017	7/18/2019
Inactive	Federal Insurance Company	301144	Agent - Health	7/10/2017	9/30/2020
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	8/27/2018	9/30/2020
Inactive	Golden Rule Insurance Company	301943	Agent - Health	5/22/2017	10/6/2020
Inactive	Golden Rule Insurance Company	301943	Agent - Life	5/22/2017	10/6/2020
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Health	8/14/2017	12/6/2018
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Life	8/14/2017	12/6/2018
Inactive	SilverScript Insurance Company	663526	Agent - Health	8/23/2019	9/30/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Life	4/13/2018	9/30/2020
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Health	4/13/2018	9/30/2020