Adjusters' licenses shall be in such form as the commissioner prescribes. The licenses shall contain:
(1) The name of the adjuster, and the address of the adjuster's place of business;
(2) A statement as to whether the adjuster is so licensed as an independent adjuster or as a public adjuster;
(3) Date of issuance of the license; and
(4) Other statements proper to the purposes of the license.