DEPARTMENT OF INSURANCE

Affiliations

Name	Black, Shelley L	DOIID	340256	NAIC NPN	3396725

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Apprentice Adjuster	Not Applicable	8/14/1996	8/14/1997
Active	Non Resident	Staff Adjuster	Property & Casualty	3/29/2013		11/30/2025
* 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
Staff Adjuster	09/15/2025	11/30/2025