| Entity Name: | FORT WALTON BEACH FACIAL TRAUMA, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 31 Oct 2019 (5 years ago) |
| Document Number: | L19000273146 |
| FEI/EIN Number | 61-1259833 |
| Address: | 1032 MAR WALT DRIVE, SUITE 100, FORT WALTON BEACH, FL, 32547, US |
| Mail Address: | 1032 MAR WALT DRIVE, SUITE 100, FORT WALTON BEACH, FL, 32547, US |
| ZIP code: | 32547 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| Name | Role | Address |
|---|---|---|
| SIEFKER JOSEPH D | Agent | 1032 MAR WALT DRIVE, FORT WALTON BEACH, FL, 32547 |
| Name | Role | Address |
|---|---|---|
| SIEFKER JOSEPH D | Authorized Member | 1032 MAR WALT DRIVE, STE 100, FORT WALTON BEACH, FL, 32547 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-15 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-03-09 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-03-24 |
| Florida Limited Liability | 2019-10-31 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
