DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Dougherty, Tracy M	DOIID	591092	NAIC NPN	7709823

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Administrator	Not Applicable	6/10/2004	5/31/2021
Active	Non Resident	Independent Adjuster	Workers' Compensation	4/1/2024		5/31/2025
* 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
Independent Adjuster	03/15/2025	05/31/2025

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Disability Reinsurance Management Services Inc.	394470	Administrator - Not Applicable	6/10/2004	5/31/2021