Individual Information

ANTONIETTE ROCHE CLARK

Address:

LEWISVILLE, TX 75057-6459

Status:

Active

Email:

licensing@bakerintl.com

Date:

03/01/2002

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	83700	03/01/2002	Active	03/01/2002	03/31/2026

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	03/01/2002	Active	03/01/2002
Property	03/01/2002	Active	03/01/2002
Casualty	03/01/2002	Inactive	03/01/2002
Property	03/01/2002	Inactive	03/01/2002

Company Name	Appointment Type	Status	Active Date
1710
ENDURANCE AMERICAN INSURANCE COMPANY	Casualty	Active	06/29/2016
	Property	Active	06/29/2016

row(s) 1 - 2 of 2

Organization	Association Type	Type	Beg dte	End dte
BAKER INTERNATIONAL INSURANCE AGENCY	Designated Resp Lic Prdcr	Agency	09/16/2020	-

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