black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

KRISTAL DAWN BLOSSER

PRODUCER NON-RESIDENT

License Number:
PRN113621
Status:
First Licensure:
05/09/2005
Cancel Date:
None

Mailing:
GOSHEN, IN 46528
Phone:
+1 (770) 250-0209
Fax:
+1 (678) 919-1151
Email:
kristal.blosser@ioausa.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 05/09/2005

Agency

Name Issue Date License Number Expiration Date Cancel Date
1ST SOURCE INSURANCE, INC
03/23/2022 AGN414061 07/01/2023
HYLANT GROUP INC
04/20/2026 AGN85201

Employer

Name Issue Date License Number Expiration Date Cancel Date
FIRST LIBERTY INSURANCE CORPORATION
06/14/2005 PCF31779 09/30/2005
LIBERTY INSURANCE CORPORATION
06/14/2005 PCF999 09/30/2005
LIBERTY MUTUAL FIRE INSURANCE COMPANY
06/14/2005 PCF330 09/30/2005

Authority

Description Issue Date Termination Date Status
CASUALTY 05/09/2005 Active
PROPERTY 05/09/2005 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
7877546

Other Addresses

Address Type
100 GALLERIA PKWY SE STE 600
ATLANTA, GA 30339-5947
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: 06/21/2026 10:21:41 PM