Individual Information

TYRONE M CLARK

ENGLEWOOD, CO 80112-3895

Active

tclark@brokerschoice.com

01/25/1999

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	58234	10/01/2001	Active	10/01/2001	01/31/2026

Qualification Type	Original Issue Date	Status	Effective Date
Health	10/01/2001	Active	10/01/2001
Life	10/01/2001	Active	10/01/2001
Health	01/25/1999	Inactive	10/01/2001
Health	01/16/2002	Inactive	01/16/2002
Life	01/25/1999	Inactive	10/01/2001
Life	01/16/2002	Inactive	01/16/2002

Company Name	Appointment Type	Status	Active Date
153630
AMERICAN LIFE & SECURITY CORP	Life	Active	05/18/2022
146762
Company Name	Appointment Type	Status	Active Date
ATLANTIC COAST LIFE INSURANCE COMPANY	Health	Active	06/25/2022
	Life	Active	06/25/2022
1632
Company Name	Appointment Type	Status	Active Date
COLUMBUS LIFE INSURANCE COMPANY	Life	Active	07/22/2016
239
Company Name	Appointment Type	Status	Active Date
FIDELITY & GUARANTY LIFE INSURANCE COMPANY	Life	Active	01/27/2014
132418
Company Name	Appointment Type	Status	Active Date
GCU	Life	Active	08/22/2023
457
Company Name	Appointment Type	Status	Active Date
NATIONAL WESTERN LIFE INSURANCE COMPANY	Life	Active	05/29/2009
596
Company Name	Appointment Type	Status	Active Date
SENTINEL SECURITY LIFE INSURANCE COMPANY	Health	Active	12/12/2018
	Life	Active	12/12/2018
1451
Company Name	Appointment Type	Status	Active Date
UPSTREAM LIFE INSURANCE COMPANY	Life	Active	05/21/2020

row(s) 1 - 10 of 10

Organization	Association Type	Type	Beg dte	End dte
BROKERS CHOICE OF AMERICA INC	Designated Resp Lic Prdcr	Agency	11/19/2020	-

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