Detail by Officer/Registered Agent Name

Florida Not For Profit Corporation

FIPA REGION #6, INC.

Filing Information
N94000000647 59-3224871 02/08/1994 FL INACTIVE ADMIN DISSOLUTION FOR ANNUAL REPORT 09/24/1999 NONE
Principal Address
408 W. UNIVERSITY AVE.
STE. 108
GAINESVILLE, FL 32601

Changed: 02/17/1998
Mailing Address
408 W. UNIVERSITY AVE.
STE. 108
GAINESVILLE, FL 32601

Changed: 02/17/1998
Registered Agent Name & Address HEYSEK, RANDY VMD
408 W. UNIVERSITY AVE.
STE. 108
GAINESVILLE, FL 32601

Name Changed: 08/14/1997

Address Changed: 02/17/1998
Officer/Director Detail Name & Address

Title D

AGLIANO, DENNIS
4600 N. HABANA AVE., SUITE 23
TAMPA, FL 33614

Title D

COCKBURN, ALDEN G
4700 N. HABANA AVE., SUITE 500
TAMPA, FL 33614

Title T

WELCH, DANIEL W
407 AVE. K SE
WINTERHAVEN, FL 33880

Title PD

HEYSEK, RANDY VMD
1324 LAKELAND HILLS BLVD
LAKELAND, FL

Title S

LORENZO, MARCOS FMD
5802 N. 30TH ST.
TAMPA, FL 33610

Annual Reports
Report YearFiled Date
1996 03/06/1996
1997 08/14/1997
1998 02/17/1998