DEPARTMENT OF INSURANCE

Affiliations

Name	Green, Shannon S	DOIID	599336	NAIC NPN	7832254

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Adjuster	Independent	12/2/2004	3/16/2007
Inactive	Non Resident	Independent Adjuster	Workers' Compensation	2/20/2013	5/31/2019
* 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	Sedgwick Claims Management Service Inc	401194	Adjuster - Independent	8/12/2005	3/16/2007