Each escrow agent license, each escrow agent branch office license, and each escrow officer license shall be issued in the form and size prescribed by the director and shall state in addition to any other matter required by the director:

(1) The name of the licensee;

(2) The name under which the applicant will do business;

(3) The address at which the applicant will do business;

(4) The expiration date of the license; and

(5) In the case of a corporation, partnership, or branch office, the name of the designated escrow officer or designated branch escrow officer.