black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

BETHANY R. CLARK

PRODUCER NON-RESIDENT

License Number:
PRN450380
Status:
First Licensure:
04/28/2023
Cancel Date:
None

Mailing:
WHITEHOUSE, TX 75791
Phone:
+1 (903) 954-0218
Fax:
+1 (903) 954-0218
Email:
brclark@cxis.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 04/28/2023

Agency

None.

Employer

Name Issue Date License Number Expiration Date Cancel Date
NATIONAL SPECIALTY INSURANCE COMPANY
05/03/2023 PCF94585
STATE NATIONAL INSURANCE COMPANY INC.
05/03/2023 PCF75933

Authority

Description Issue Date Termination Date Status
CASUALTY 04/28/2023 Active
PROPERTY 04/28/2023 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
18517258

Other Addresses

Address Type
360 CENTRAL AVE STE 250
ST PETERSBURG, FL 33701-3832
Office

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 05/17/2025 06:44:36 AM