DEPARTMENT OF INSURANCE

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
Active	Resident	Agent	Health	7/10/2023		4/30/2025
Active	Resident	Agent	Casualty	10/25/2023		4/30/2025
Active	Resident	Agent	Life	7/10/2023		4/30/2025
Active	Resident	Agent	Property	10/25/2023		4/30/2025
Inactive	Resident	Agent	Limited Line Credit	7/19/2013	4/30/2023

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

No License Renewal Information

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date. Licensees subject to CE must complete CE requirements before Next Compliance Date in order to successfully complete the License Renewal Process.

Address Information

Type	Address
Business / Home Office	315 Bellefonte Princess Rd. Ashland, KY 41101
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(606) 316-7275