| Entity Name: | CRESTVIEW MEDICAL CLINIC LABORATORY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 29 Mar 1989 (36 years ago) |
| Document Number: | K77706 |
| FEI/EIN Number | 592947432 |
| Address: | % JAMES L. CHASE, 101 EAST GOVERNMENT ST., PENSACOLA, FL, 32501 |
| Mail Address: | % JAMES L. CHASE, 101 EAST GOVERNMENT ST., PENSACOLA, FL, 32501 |
| ZIP code: | 32501 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| Name | Role | Address |
|---|---|---|
| CHASE, JAMES L. | Agent | 101 EAST GOVERNMENT AVE., PENSACOLA, FL, 32501 |
| Name | Role | Address |
|---|---|---|
| CAMPBELL, WAYNE E. M.D. | Director | 130 REDSTONE AVE., CRESTVIEW, FL |
| CAMPBELL, DAVID M. M.D. | Director | 130 REDSTONE AVE., CRESTVIEW, FL |
| THIGPEN, R. LEE M.D. | Director | 130 REDSTONE AVE., CRESTVIEW, FL |
| JOHNSON, JOHN T. | Director | 130 REDSTONE AVE., CRESTVIEW, FL |
| Name | Role | Address |
|---|---|---|
| SMITH, RICK E., R.T. | President | 130 REDSTONE AVENUE, CRESTVIEW, FL |
| Name | Role | Address |
|---|---|---|
| PANGLE, GARY W., M.T. | Vice President | 130 REDSTONE AVENUE, CRESTVIEW, FL |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 1991-12-30 | No data | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
