DEPARTMENT OF INSURANCE

Name	Busch, Nicole L	DOIID	839789	NAIC NPN	15310017

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Non Resident	Independent Adjuster	Property & Casualty	5/1/2014	3/23/2021
Pending Replacement	Non Resident	Staff Adjuster	Property & Casualty	4/5/2021		4/30/2025	Indiana

*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	02/15/2025	04/30/2025

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
Business / Home Office	One Qbe Way Sun Prairie, WI 535960001
Residence	Not Public Information

Internet Information

Type	Address
Business Email	nicole.busch@us.qbe.com

Phone Information

Type	Phone
Business / Home Office	(608) 825-5320