DEPARTMENT OF INSURANCE

Name	Breitenbach, Mark Christopher	DOIID	665689	NAIC NPN	6907592

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Active	Non Resident	Independent Adjuster	Property & Casualty	3/10/2009		12/31/2024

*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	10/15/2024	12/31/2024

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
Residence	Not Public Information
Business / Home Office	Axa Xl/Xl Specialty Insurance Company 3340 Peachtree Rd Ne Ste 2140Atlanta, GA 303261084

Phone Information

Type	Phone
Business / Home Office	(404) 249-1845