| Entity Name: | RICHARD D. CARLSON, D.M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 19 Feb 2004 (21 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | P04000033179 |
| FEI/EIN Number | 830387113 |
| Address: | 13241 BARTRAM PARK BLVD, BLDG 1700, JACKSONVILLE, FL, 32258, US |
| Mail Address: | 13241 BARTRAM PARK BLVD, BLDG 1700, JACKSONVILLE, FL, 32258, US |
| ZIP code: | 32258 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RICHARD D CARLSON D M D P A 401 K PROFIT SHARING PLAN TRUST | 2014 | 830387113 | 2015-07-14 | RICHARD D CARLSON D M D P A | 25 | |||||||||||||||||||||||
|
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| Role | Plan administrator |
| Date | 2015-07-14 |
| Name of individual signing | RICHARD CARLSON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2002-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 9042628409 |
| Plan sponsor’s address | 13241 BARTRAM PARK BLVD # 1700, JACKSONVILLE, FL, 322585212 |
Signature of
| Role | Plan administrator |
| Date | 2014-07-09 |
| Name of individual signing | RICHARD D. CARLSON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2002-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 9042628409 |
| Plan sponsor’s address | 13241 BARTRAM PARK BLVD # 1700, JACKSONVILLE, FL, 322585212 |
Signature of
| Role | Plan administrator |
| Date | 2013-07-25 |
| Name of individual signing | RICHARD D CARLSON D M D P A |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| GLAZIER, GLAZIER & DIETRICH, P.A. | Agent |
| Name | Role | Address |
|---|---|---|
| CARLSON RICHARD D | President | 13241 BARTRAM PARK BLVD., JACKSONVILLE, FL, 32258 |
| Name | Role | Address |
|---|---|---|
| CARLSON RICHARD D | Secretary | 13241 BARTRAM PARK BLVD., JACKSONVILLE, FL, 32258 |
| Name | Role | Address |
|---|---|---|
| CARLSON RICHARD D | Director | 13241 BARTRAM PARK BLVD., JACKSONVILLE, FL, 32258 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-26 | 8833 PERIMETER PARK BLVD., SUITE 1002, JACKSONVILLE, FL 32216 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-10-24 | 13241 BARTRAM PARK BLVD, BLDG 1700, JACKSONVILLE, FL 32258 | No data |
| CHANGE OF MAILING ADDRESS | 2008-10-24 | 13241 BARTRAM PARK BLVD, BLDG 1700, JACKSONVILLE, FL 32258 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-04-18 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-04-30 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-04-26 |
| ANNUAL REPORT | 2016-04-28 |
| ANNUAL REPORT | 2015-04-23 |
| ANNUAL REPORT | 2014-03-24 |
| ANNUAL REPORT | 2013-04-29 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
