DEPARTMENT OF INSURANCE

Affiliations

Name	Mullins, Kelly Jo	DOIID	680577	NAIC NPN	8411175

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Independent Adjuster	Workers' Compensation	5/12/2008	11/15/2021
Active	Non Resident	Staff Adjuster	Workers' Compensation	11/15/2021		5/31/2026
* 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	Broadspire Services, Inc.	396187	Independent Adjuster - Workers' Compensation	3/20/2018	11/15/2021