Detail by Officer/Registered Agent Name

Florida Profit Corporation

FLORIDA MEDICAL GROUP OF HOLLYWOOD, INC.

Filing Information
L54116 65-0179318 03/01/1990 FL INACTIVE ADMIN DISSOLUTION FOR ANNUAL REPORT 09/26/1997 NONE
Principal Address
5201 HOLLYWOOD BLVD
2ND FLR
HOLLYWOOD, FL 33021

Changed: 04/17/1995
Mailing Address
3510 RIDGELAND RD
DAVIE, FL 33328

Changed: 04/17/1995
Registered Agent Name & Address PLEETER, LOUIS J.
ONE BOCA PLACE
2255 GLADES ROAD, STE 236W
BOCA RATON, FL 33431

Name Changed: 03/12/1990

Address Changed: 04/17/1995
Officer/Director Detail Name & Address

Title D

FIELDS, ALLAN N.
8606 STATE ROAD 84
DAVIE, FL

Title D

BOLTON, EDGAR B., JR.
8606 STATE ROAD 84
DAVIE, FL

Title D

HALADEY, ROBERT
8606 STATE ROAD 84
DAVIE, FL

Annual Reports
Report YearFiled Date
1994 04/22/1994
1995 04/17/1995
1996 04/26/1996