DEPARTMENT OF INSURANCE

Affiliations

Name	Fuller, Keith Stewart	DOIID	659741	NAIC NPN	3345949

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Adjuster	Independent	7/16/2007	4/3/2010
* 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	Custard Insurance Adjusters Inc.	401182	Adjuster - Independent	8/24/2009	2/18/2010