DEPARTMENT OF INSURANCE

Name	Street, Crystal	DOIID	534622	NAIC NPN	7218660

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	1/4/2002	10/9/2002
Inactive	Non Resident	Apprentice Adjuster	Not Applicable	8/14/2001	5/7/2002

*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
Residence	Not Public Information
Business / Home Office	8900 Keystone Crossing Suite 300Indianapolis, IN 46240

Phone Information

Type	Phone
Fax	(317) 587-2867
Business / Home Office	(317) 587-2968