DEPARTMENT OF INSURANCE

Name	Clark, Dale Edward	DOIID	307730	NAIC NPN	256539

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Casualty	8/15/2000	1/31/2015
Inactive	Non Resident	Agent	Property	8/15/2000	1/31/2015
Inactive	Non Resident	Agent	General Lines	3/22/1988	8/15/2000

*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	10710 Sikes Pl Ste 125 Charlotte, NC 282778199
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(704) 366-6847