Detail by Officer/Registered Agent Name

Florida Profit Corporation

FLORIDA HEALTH SOURCE OF BROWARD, INC.

Filing Information
P03000112349 20-0304533 10/10/2003 FL INACTIVE ADMIN DISSOLUTION FOR ANNUAL REPORT 09/16/2005 NONE
Principal Address
350 JIM MORAN BLVD
DEERFIELD BEACH, FL 33442
Mailing Address
350 JIM MORAN BLVD
DEERFIELD BEACH, FL 33442
Registered Agent Name & Address BLOOM, JONATHAN ESQ
BLOOM, BALLEN AND FREELING
2295 NW CORPORATE BLVD., STE 117
BOCA RATON, FL 33431

Name Changed: 05/03/2004

Address Changed: 05/03/2004
Officer/Director Detail Name & Address

Title PTD

BROVENICK, EVAN
350 JIM MORAN BLVD
DEERFIELD BEACH, FL 33442

Title SD

BLECHMAN, DAVID
350 JIM MORAN BLVD
DEERFIELD BEACH, FL 33442

Annual Reports
Report YearFiled Date
2004 05/03/2004