ERIC CLARK

Agent ID:	10225851
National Producer ID:	16360151
Mailing Address:	5814 REED ROAD
	FORT WAYNE, IN 46835
Resident State:	IN
Phone:	800-463-3776

Agent License

Type	Status	Issue Date	Expiration Date
Insurance Producer	Active	8/29/2011	1/31/2025

Notice: As a result of a data conversion some licenses and qualifications reflect a 10/27/2009 issue date when in fact the license may have been held prior to this date. If you have any questions about the issue date of a license, please contact the Licensing Division of the Mississippi Insurance Department by telephone 601-359-3582 or by email at licensing@mid.ms.gov.

Agent Qualifications

Type	Issue Date
Casualty	8/29/2011
Property	8/29/2011

Agent Appointments

1 Records Found

License Number	Company Name	Issue Date
8900035	Medical Protective Company, The	9/6/2011