DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Wilson, Mary Jo	DOIID	1189450	NAIC NPN	19165845

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	2/22/2022		8/31/2025
Active	Non Resident	Agent	Property	2/22/2022		8/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	2/22/2022		8/31/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	06/15/2025	08/31/2025
Surplus Lines Broker	06/15/2025	08/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Liberty Mutual Fire Insurance Company	301913	Agent - Casualty	12/12/2022
Active	Liberty Mutual Fire Insurance Company	301913	Agent - Property	12/12/2022
Active	Liberty Mutual Insurance Company	301159	Agent - Casualty	12/12/2022
Active	Liberty Mutual Insurance Company	301159	Agent - Property	12/12/2022
Active	State Automobile Mutual Insurance Company	301824	Agent - Casualty	3/22/2025
Active	State Automobile Mutual Insurance Company	301824	Agent - Property	3/22/2025

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	CRC Ins Services, LLC	502276	Agent - Casualty	12/12/2022
Active	CRC Ins Services, LLC	502276	Agent - Property	12/12/2022
Active	CRC Ins Services, LLC	502276	Surplus Lines Broker - Not Applicable	12/6/2022