DEPARTMENT OF INSURANCE

Name	Ortiz, Nicolas Corbin	DOIID	769292	NAIC NPN	16390614

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Non Resident	Agent	Personal Lines	11/19/2011	12/31/2016
Active	Non Resident	Staff Adjuster	Property & Casualty	8/17/2021		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
Staff 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	2775 Sanders Rd Ste Bg Northbrook, IL 60062

Phone Information

Type	Phone
Business / Home Office	(847) 226-1928