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  5. MEDICAL LICENSURE GROUP, LLC

MEDICAL LICENSURE GROUP, LLC

Company Details

Entity Name: MEDICAL LICENSURE GROUP, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 18 Jun 2008 (17 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 10 Dec 2010 (14 years ago)
Document Number: L08000059998
FEI/EIN Number 262907873
Address: 4400 Bayou Boulevard, Suite 32B, PENSACOLA, FL, 32503, US
Mail Address: 4400 Bayou Boulevard, Suite 32B, PENSACOLA, FL, 32503, US
ZIP code: 32503
County: Escambia
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MEDICAL LICENSURE GROUP 401(K) PLAN 2023 262907873 2024-05-09 MEDICAL LICENSURE GROUP, LLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 541990
Sponsor’s telephone number 8504334600
Plan sponsor’s address 4400 BAYOU BLVD., SUITE 32B, PENSACOLA, FL, 32503

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2024-05-09
Name of individual signing QIAN LIU
Valid signature Filed with authorized/valid electronic signature
MEDICAL LICENSURE GROUP 401(K) PLAN 2022 262907873 2023-05-27 MEDICAL LICENSURE GROUP, LLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 541990
Sponsor’s telephone number 8504334600
Plan sponsor’s address 4400 BAYOU BLVD., SUITE 32B, PENSACOLA, FL, 32503

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2023-05-27
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
MEDICAL LICENSURE GROUP 401(K) PLAN 2021 262907873 2022-06-01 MEDICAL LICENSURE GROUP, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 541990
Sponsor’s telephone number 8504334600
Plan sponsor’s address 4400 BAYOU BLVD., SUITE 32B, PENSACOLA, FL, 32503

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2022-06-01
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
MEDICAL LICENSURE GROUP 401(K) PLAN 2020 262907873 2021-04-30 MEDICAL LICENSURE GROUP, LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 541990
Sponsor’s telephone number 8504334600
Plan sponsor’s address 4400 BAYOU BLVD., SUITE 32B, PENSACOLA, FL, 32503

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2021-04-30
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature
MEDICAL LICENSURE GROUP 401(K) PLAN 2019 262907873 2020-05-15 MEDICAL LICENSURE GROUP, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 541990
Sponsor’s telephone number 8504334600
Plan sponsor’s address 4400 BAYOU BLVD., SUITE 32B, PENSACOLA, FL, 32503

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2020-05-15
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature
MEDICAL LICENSURE GROUP, LLC 401(K) PROFIT SHARING PLAN 2018 262907873 2019-01-30 MEDICAL LICENSURE GROUP, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 541990
Sponsor’s telephone number 8504334600
Plan sponsor’s address 4400 BAYOU BLVD, SUITE 32B, PENSACOLA, FL, 32503

Signature of
Role Plan administrator
Date 2019-01-30
Name of individual signing STEPHEN DENSMORE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-01-30
Name of individual signing STEPHEN DENSMORE
Valid signature Filed with authorized/valid electronic signature
MEDICAL LICENSURE GROUP, LLC 401(K) PROFIT SHARING PLAN 2017 262907873 2018-01-30 MEDICAL LICENSURE GROUP, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 541990
Sponsor’s telephone number 8504334600
Plan sponsor’s address 4400 BAYOU BLVD, SUITE 32B, PENSACOLA, FL, 32503

Signature of
Role Plan administrator
Date 2018-01-30
Name of individual signing STEPHEN DENSMORE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-01-30
Name of individual signing STEPHEN DENSMORE
Valid signature Filed with authorized/valid electronic signature
MEDICAL LICENSURE GROUP, LLC 401(K) PROFIT SHARING PLAN 2016 262907873 2017-01-19 MEDICAL LICENSURE GROUP, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 541990
Sponsor’s telephone number 8504334600
Plan sponsor’s address 4400 BAYOU BLVD, SUITE 32B, PENSACOLA, FL, 32503

Signature of
Role Plan administrator
Date 2017-01-19
Name of individual signing STEPHEN DENSMORE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-01-19
Name of individual signing STEPHEN DENSMORE
Valid signature Filed with authorized/valid electronic signature
MEDICAL LICENSURE GROUP, LLC 401(K) PROFIT SHARING PLAN 2015 262907873 2016-01-20 MEDICAL LICENSURE GROUP, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 541990
Sponsor’s telephone number 8504334600
Plan sponsor’s address 4400 BAYOU BLVD, SUITE 32B, PENSACOLA, FL, 32503

Signature of
Role Plan administrator
Date 2016-01-20
Name of individual signing STEPHEN DENSMORE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-01-20
Name of individual signing STEPHEN DENSMORE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Densmore Stephen A Agent 4400 Bayou Boulevard, PENSACOLA, FL, 32503

President

Name Role Address
Morgan Lauran M President 4400 Bayou Boulevard, PENSACOLA, FL, 32503

Vice President

Name Role Address
DENSMORE STEPHEN A Vice President 4400 Bayou Boulevard, PENSACOLA, FL, 32503

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2023-01-04 Densmore, Stephen A No data
CHANGE OF PRINCIPAL ADDRESS 2015-01-07 4400 Bayou Boulevard, Suite 32B, PENSACOLA, FL 32503 No data
CHANGE OF MAILING ADDRESS 2015-01-07 4400 Bayou Boulevard, Suite 32B, PENSACOLA, FL 32503 No data
REGISTERED AGENT ADDRESS CHANGED 2015-01-07 4400 Bayou Boulevard, Suite 32B, PENSACOLA, FL 32503 No data
REINSTATEMENT 2010-12-10 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2009-09-25 No data No data

Documents

Name Date
ANNUAL REPORT 2024-01-16
ANNUAL REPORT 2023-01-04
ANNUAL REPORT 2022-01-10
ANNUAL REPORT 2021-01-28
ANNUAL REPORT 2020-01-06
ANNUAL REPORT 2019-01-06
ANNUAL REPORT 2018-01-09
ANNUAL REPORT 2017-01-10
ANNUAL REPORT 2016-01-22
ANNUAL REPORT 2015-01-07

Related by officers

DENSMORE STEPHEN A

SIERRA DELTA PROPERTIES, LLC RAMPART PENSACOLA, LLC

Related by address

No related companies by address

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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