Detail by Officer/Registered Agent Name

Florida Limited Liability Company

BLUE WATER DOCTORS OF LAKE WORTH, LLC

Filing Information
L12000121869 46-1043560 09/24/2012 08/08/2013 FL INACTIVE VOLUNTARY DISSOLUTION 01/12/2016 NONE
Principal Address
3472 FOREST HILL BLVD,STE 2C
PALM SPRINGS, FL 33406
Mailing Address
3472 FOREST HILL BLVD,STE 2C
PALM SPRINGS, FL 33406
Registered Agent Name & Address HINMAN, ROY H, MD
100 ARRICOLA AVE
ST. AUGUSTINE, FL 32080

Name Changed: 04/14/2015

Address Changed: 04/14/2015
Authorized Person(s) Detail Name & Address

Title MGRM

BASSETT, ROY, MD
3472 FOREST HILL BLVD,STE 2C
PALM SPRINGS, FL 33406

Title MGR

George, Sadowski, MD PA
2460 Gold Moultrie Road
Suite 3
St. Augustine, FL 32086

Annual Reports
Report YearFiled Date
2013 04/29/2013
2014 01/10/2014
2015 04/14/2015