DEPARTMENT OF INSURANCE

Name	Wagner, Keith J	DOIID	1148508	NAIC NPN	20006318

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Active	Non Resident	Independent Adjuster	Property & Casualty	8/2/2021		10/31/2024	Texas

*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	08/15/2024	10/31/2024

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date. Licensees subject to CE must complete CE requirements before Next Compliance Date in order to successfully complete the License Renewal Process.

Address Information

Type	Address
Business / Home Office	11231 Us Hwy 1 Apt 110 North Palm Beach, FL 33408
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(917) 829-3681