Detail by Officer/Registered Agent Name

Florida Profit Corporation

MEDISYS FORMS & SUPPLIES, INC.

Filing Information
P95000022503 65-0651868 03/20/1995 FL INACTIVE ADMIN DISSOLUTION FOR ANNUAL REPORT 09/22/2000 NONE
Principal Address
3912 NORTH 29TH AVENUE
HOLLYWOOD, FL 33020
Mailing Address
2500 NW 79TH AVE
LEGAL DEPARTMENT
MIAMI, FL 33122

Changed: 04/20/1998
Registered Agent Name & Address CONE, PERRY I.
2500 N.W. 79TH AVENUE
MIAMI, FL 33122

Name Changed: 04/20/1998

Address Changed: 04/20/1998
Officer/Director Detail Name & Address

Title DP

ESPER, GEORGE
3912 N. 29 AVE.
HOLLYWOOD, FL

Title DC

ALVAREZ, JOSE M.
2500 NW 79 AVE.
MIMAI, FL

Title DV

ESPER, AL
3912 N. 29 AVE.
HOLLYWOOD, FL

Title DT

TORGAS, ED. S.
2500 NW 79 AVE.
MIAMI, FL

Title DV

FERNANDEZ, SERGIO
2500 NW 79 AVE.
MIAMI, FL

Title S

CONE, PERRY I
2500 NW 79 AVE.
MIAMI, FL 33122

Annual Reports
Report YearFiled Date
1997 05/02/1997
1998 04/20/1998
1999 04/20/1999