DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Willmeth, Shannon Laurie	DOIID	624536	NAIC NPN	3694221

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Adjuster	Independent	2/2/2006	8/31/2007
Inactive	Non Resident	Independent Adjuster	Workers' Compensation	4/21/2008	8/31/2015
* 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	Independent Adjuster - Workers' Compensation	11/20/2012	8/31/2015
Inactive	Specialty Risk Services LLC	596363	Independent Adjuster - Workers' Compensation	2/12/2010	11/19/2012