DEPARTMENT OF INSURANCE

Name	Keller, Mark Lowry	DOIID	501947	NAIC NPN	1678601

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	8/15/2000		3/31/2026
Active	Non Resident	Agent	Property	8/15/2000		3/31/2026
Inactive	Non Resident	Agent	General Lines	2/7/2000	8/15/2000
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	12/18/2008	9/4/2015

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

No License Renewal Information

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	3135 Highway 471 Brandon, MS 390477450
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(855) 804-5222 Ext-536