LOUISE I. BUHRMANN, M.D., P.A.
|
2017
|
202091554
|
2018-05-21
|
LOUISE I. BUHRMANN, M.D., P.A.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2009-04-01
|
Business code |
621111
|
Sponsor’s telephone number |
4076712258
|
Plan sponsor’s
address |
1035 S SEMORAN BLVD, SUITE 1027 BUILDING 2, WINTER PARK, FL, 32792
|
Signature of
Role |
Plan administrator |
Date |
2018-05-21 |
Name of individual signing |
LOUISE I BUHRMANN, MD PA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LOUISE I. BUHRMANN, MD, PA
|
2017
|
202091554
|
2018-08-06
|
LOUISE I. BUHRMANN, M.D., P.A.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2009-04-01
|
Business code |
621111
|
Sponsor’s telephone number |
4076712258
|
Plan sponsor’s
address |
1035 S SEMORAN BLVD, BUILDING 2 SUITE 1027, WINTER PARK, FL, 32792
|
Signature of
Role |
Plan administrator |
Date |
2018-08-06 |
Name of individual signing |
LOUISE I BUHRMANN, MD PA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LOUISE I. BUHRMANN, M.D., P.A.
|
2016
|
202091554
|
2017-06-09
|
LOUISE I. BUHRMANN, M.D., P.A.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2009-04-01
|
Business code |
621111
|
Sponsor’s telephone number |
4076712258
|
Plan sponsor’s
address |
1035 S SEMORAN BLVD, SUITE 1027 BUILDING 2, WINTER PARK, FL, 32792
|
Signature of
Role |
Plan administrator |
Date |
2017-06-09 |
Name of individual signing |
LOUISE I BUHRMANN, MD PA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LOUISE I. BUHRMANN, M.D., P.A.
|
2015
|
202091554
|
2016-07-19
|
LOUISE I. BUHRMANN, M.D., P.A.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2009-04-01
|
Business code |
621111
|
Sponsor’s telephone number |
4076712258
|
Plan sponsor’s
address |
1035 S SEMORAN BLVD, SUITE 1027 BUILDING 2, WINTER PARK, FL, 32792
|
|
LOUISE I. BUHRMANN, M.D., P.A.
|
2014
|
202091554
|
2015-07-17
|
LOUISE I. BUHRMANN, M.D., P.A.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2009-04-01
|
Business code |
621111
|
Sponsor’s telephone number |
4076712258
|
Plan sponsor’s
address |
1035 S SEMORAN BLVD, SUITE 1027 BUILDING 2, WINTER PARK, FL, 32792
|
Signature of
Role |
Plan administrator |
Date |
2015-07-17 |
Name of individual signing |
LOUISE I. BUHRMANN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LOUISE I. BUHRMANN, M.D., P.A.
|
2013
|
202091554
|
2014-07-25
|
LOUISE I. BUHRMANN, M.D., P.A.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2009-04-01
|
Business code |
621111
|
Sponsor’s telephone number |
4076712258
|
Plan sponsor’s
address |
1035 S SEMORAN BLVD, SUITE 1027 BUILDING 2, WINTER PARK, FL, 32792
|
Signature of
Role |
Plan administrator |
Date |
2014-07-25 |
Name of individual signing |
FRANK HARRISON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LOUISE I. BUHRMANN, M.D., P.A.
|
2013
|
202091554
|
2014-06-03
|
LOUISE I. BUHRMANN, M.D., P.A.
|
4
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2009-04-01
|
Business code |
621111
|
Sponsor’s telephone number |
4076712258
|
Plan sponsor’s
address |
1035 S SEMORAN BLVD, SUITE 1027 BUILDING 2, WINTER PARK, FL, 32792
|
Signature of
Role |
Plan administrator |
Date |
2014-06-03 |
Name of individual signing |
LOUISE I. BUHRMANN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LOUISE I. BUHRMANN, M.D., P.A.
|
2012
|
202091554
|
2013-03-29
|
LOUISE I. BUHRMANN, M.D., P.A.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2009-04-01
|
Business code |
621111
|
Sponsor’s telephone number |
4076712258
|
Plan sponsor’s
address |
1485 S. SEMORAN BLVD., SUITE 1454, WINTER PARK, FL, 32792
|
Signature of
Role |
Plan administrator |
Date |
2013-03-29 |
Name of individual signing |
LOUISE I. BUHRMANN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LOUISE I. BUHRMANN, M.D., P.A.
|
2011
|
202091554
|
2012-06-20
|
LOUISE I. BUHRMANN, M.D., P.A.
|
4
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2009-04-01
|
Business code |
621111
|
Sponsor’s telephone number |
4076712258
|
Plan sponsor’s
address |
1485 S. SEMORAN BLVD., SUITE 1454, WINTER PARK, FL, 32792
|
Plan administrator’s name and address
Administrator’s EIN |
202091554 |
Plan administrator’s name |
LOUISE I. BUHRMANN, M.D., P.A. |
Plan administrator’s
address |
1485 S. SEMORAN BLVD., SUITE 1454, WINTER PARK, FL, 32792 |
Administrator’s telephone number |
4076712258 |
Signature of
Role |
Plan administrator |
Date |
2012-06-20 |
Name of individual signing |
LOUISE I. BUHRMANN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LOUISE I. BUHRMANN, M.D., P.A.
|
2011
|
202091554
|
2012-06-21
|
LOUISE I. BUHRMANN, M.D., P.A.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2009-04-01
|
Business code |
621111
|
Sponsor’s telephone number |
4076712258
|
Plan sponsor’s
address |
1485 S. SEMORAN BLVD., SUITE 1454, WINTER PARK, FL, 32792
|
Plan administrator’s name and address
Administrator’s EIN |
202091554 |
Plan administrator’s name |
LOUISE I. BUHRMANN, M.D., P.A. |
Plan administrator’s
address |
1485 S. SEMORAN BLVD., SUITE 1454, WINTER PARK, FL, 32792 |
Administrator’s telephone number |
4076712258 |
Signature of
Role |
Plan administrator |
Date |
2012-06-21 |
Name of individual signing |
LOUISE I. BUHRMANN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|