DEPARTMENT OF INSURANCE

Name	Clark, Michael	DOIID	1055016	NAIC NPN	6592793

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Casualty	11/19/2020	9/30/2025
Active	Non Resident	Agent	Life	9/6/2019	9/30/2025
Active	Non Resident	Agent	Property	11/19/2020	9/30/2025
Active	Non Resident	Agent	Health	9/6/2019	9/30/2025

*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	07/15/2025	09/30/2025

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	151 Scenic Dr Apt D Mooresville, NC 281155121
Residence	Not Public Information

Internet Information

Type	Address
Business Email	mtclark1@outlook.com

Phone Information

Type	Phone
Business / Home Office	(704) 677-9831