DEPARTMENT OF INSURANCE

Affiliations

Name	Mickelsen, Susan M	DOIID	384491	NAIC NPN	7206524

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Adjuster	Independent	1/24/2001	8/6/2004
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	MSI Risk Management Services, Inc	540732	Adjuster - Independent	10/24/2001	8/6/2004