DEPARTMENT OF INSURANCE

Name	Anderson, Kelley	DOIID	895236	NAIC NPN	17726200

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Non Resident	Administrator	Not Applicable	2/2/2016	11/30/2017
Active	Non Resident	Independent Adjuster	Property & Casualty	5/13/2022		11/30/2027	North Carolina
Inactive	Non Resident	Public Adjuster	Property & Casualty	10/13/2015	11/30/2017
Inactive	Non Resident	Staff Adjuster	Property & Casualty	6/12/2019	11/30/2021

*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	4636 Lebanon Pike # 176 Hermitage, TN 370761316
Residence	Not Public Information

Internet Information

Type	Address
Business Email	origin@3hcs.com

Phone Information

Type	Phone
Business / Home Office	(636) 345-9347