| Entity Name: | BRIAN A. LASSETER, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 25 Aug 2003 (21 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | P03000094294 |
| FEI/EIN Number | 810630011 |
| Address: | 3339 NE Luna Terrace, JENSEN BEACH, FL, 34957, US |
| Mail Address: | 3339 NE LUNA TERRACE, JENSEN BEACH, FL, 34957 |
| ZIP code: | 34957 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRIAN A LASSETER M D P A 401(K) TRUST | 2012 | 810630011 | 2013-08-20 | BRIAN A LASSETER M D P A | 2 | |||||||||||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2013-08-20 |
| Name of individual signing | BRIAN LASSETER, MD |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2013-08-20 |
| Name of individual signing | BRIAN LASSETER, MD |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2004-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 7723341700 |
| Plan sponsor’s address | 1801 NE JENSEN BEACH BLVD, JENSEN BEACH, FL, 34957 |
Signature of
| Role | Plan administrator |
| Date | 2013-08-20 |
| Name of individual signing | BRIAN LASSETER, MD |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2013-08-20 |
| Name of individual signing | BRIAN LASSETER, MD |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2004-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 7723341700 |
| Plan sponsor’s address | 1801 NE JENSEN BEACH BLVD, JENSEN BEACH, FL, 34957 |
Plan administrator’s name and address
| Administrator’s EIN | 810630011 |
| Plan administrator’s name | BRIAN A LASSETER M D P A |
| Plan administrator’s address | 1801 NE JENSEN BEACH BLVD, JENSEN BEACH, FL, 34957 |
| Administrator’s telephone number | 7723341700 |
Signature of
| Role | Plan administrator |
| Date | 2012-10-04 |
| Name of individual signing | BRIAN A. LASSETER |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2012-10-04 |
| Name of individual signing | BRIAN A. LASSETER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2004-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 7723341700 |
| Plan sponsor’s address | 1801 NE JENSEN BEACH BLVD, JENSEN BEACH, FL, 34957 |
Plan administrator’s name and address
| Administrator’s EIN | 810630011 |
| Plan administrator’s name | BRIAN A LASSETER M D P A |
| Plan administrator’s address | 1801 NE JENSEN BEACH BLVD, JENSEN BEACH, FL, 34957 |
| Administrator’s telephone number | 7723341700 |
Signature of
| Role | Plan administrator |
| Date | 2011-10-11 |
| Name of individual signing | BRIAN LASSETER |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2011-10-11 |
| Name of individual signing | BRIAN LASSETER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2004-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 7723341700 |
| Plan sponsor’s address | 1801 NE JENSEN BEACH BLVD, JENSEN BEACH, FL, 34957 |
Plan administrator’s name and address
| Administrator’s EIN | 810630011 |
| Plan administrator’s name | BRIAN A LASSETER M D P A |
| Plan administrator’s address | 1801 NE JENSEN BEACH BLVD, JENSEN BEACH, FL, 34957 |
| Administrator’s telephone number | 7723341700 |
Signature of
| Role | Plan administrator |
| Date | 2010-10-07 |
| Name of individual signing | BRIAN LASSETER MD |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-10-07 |
| Name of individual signing | BRIAN LASSETER MD |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| LASSETER BRIAN A | Agent | 3339 NE Luna Terrace, JENSEN BEACH, FL, 34957 |
| Name | Role | Address |
|---|---|---|
| LASSETER BRIAN A | Director | 3339 NE LUNA TERRACE, JENSEN BEACH, FL, 34957 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-15 | 3339 NE Luna Terrace, JENSEN BEACH, FL 34957 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-15 | 3339 NE Luna Terrace, JENSEN BEACH, FL 34957 | No data |
| REGISTERED AGENT NAME CHANGED | 2005-02-23 | LASSETER, BRIAN A | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-04-15 |
| ANNUAL REPORT | 2012-02-22 |
| ANNUAL REPORT | 2011-02-01 |
| ANNUAL REPORT | 2010-01-22 |
| ANNUAL REPORT | 2009-01-15 |
| ANNUAL REPORT | 2008-01-06 |
| ANNUAL REPORT | 2007-01-09 |
| ANNUAL REPORT | 2006-01-06 |
| ANNUAL REPORT | 2005-02-23 |
| ANNUAL REPORT | 2004-07-07 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
