DEPARTMENT OF INSURANCE

Name	Clark, Latasha	DOIID	878798	NAIC NPN	16939303

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	5/26/2015	7/31/2020
Inactive	Non Resident	Agent	Casualty	5/26/2015	7/31/2020
Active	Non Resident	Independent Adjuster	Property & Casualty	12/16/2019		7/31/2026

*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
Independent Adjuster	05/15/2024	07/31/2024	05/07/2024	05/07/2024	Yes

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
Residence	Not Public Information
Business / Home Office	9944 Winthrop St Detroit, MI 482271622

Phone Information

Type	Phone
Business / Home Office	(248) 637-3258