DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Uittenbogaard, Mark Richard	DOIID	787915	NAIC NPN	16708566

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Independent Adjuster	Property & Casualty	8/8/2012		5/31/2027
* 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
Independent Adjuster	03/15/2025	05/31/2025	04/15/2025	04/15/2025	Yes

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Sedgwick Claims Management Service Inc	401194	Independent Adjuster - Property & Casualty	11/20/2012
Inactive	Specialty Risk Services LLC	596363	Independent Adjuster - Property & Casualty	11/19/2012	11/19/2012