black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

KAY LOIS MILLER

PRODUCER NON-RESIDENT

License Number:
PRN475539
Status:
First Licensure:
02/03/2024
Cancel Date:
None

Mailing:
CARROLLTON, TX 75007
Phone:
+1 (214) 693-8462
Fax:
+1 (847) 871-9878
Email:
origin@3hcs.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 02/03/2024

Agency

Name Issue Date License Number Expiration Date Cancel Date
ORIGIN SPECIALTY UNDERWRITERS AGENCY, LLC.
02/03/2024 AGN465791

Employer

Name Issue Date License Number Expiration Date Cancel Date
GREAT AMERICAN ALLIANCE INSURANCE COMPANY
05/10/2024 PCF46804
GREAT AMERICAN INSURANCE COMPANY
05/10/2024 PCF764

Authority

Description Issue Date Termination Date Status
CASUALTY 02/03/2024 Active
PROPERTY 02/03/2024 Active
SURPLUS LINES 02/08/2024 Active

Responsible For

Name License Number
ORIGIN SPECIALTY UNDERWRITERS AGENCY, LLC. AGN465791

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
8908358

Other Addresses

Address Type
CARROLLTON, TX 75007
Office

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 01/05/2026 06:18:15 AM