DEPARTMENT OF INSURANCE

Name	Petersen, Tracy Lynn	DOIID	384075	NAIC NPN	7206345

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Non Resident	Adjuster	Independent	2/15/2002	1/22/2009
Inactive	Non Resident	Apprentice Adjuster	Not Applicable	9/12/1997	9/10/1998
Active	Non Resident	Independent Adjuster	Workers' Compensation	7/19/2021		1/31/2025	Florida
Active	Non Resident	Independent Adjuster	Property & Casualty	7/19/2021		1/31/2025	Florida
Inactive	Non Resident	Staff Adjuster	Property & Casualty	4/3/2009	7/19/2021

*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	11/15/2024	01/31/2025

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	Gallagher Bassett Services Inc 1215 Manor Dr Ste 101Mechanicsburg, PA 170554900
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(312) 930-5435