DEPARTMENT OF INSURANCE

Name	Clark Insurance	DOIID	823735	NAIC NPN	686188

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Casualty	10/9/2013	12/27/2022
Inactive	Non Resident	Agent	Property	10/9/2013	12/27/2022
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	3/17/2021	12/27/2022

*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.

Address Information

Type	Address
Business / Home Office	1945 Congress St Bldg A Portland, ME 041021903

Phone Information

Type	Phone
Business / Home Office	(207) 774-6257