| Entity Name: | JOHN R. BRENT, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 16 May 2005 (20 years ago) |
| Date of dissolution: | 30 May 2023 (2 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 30 May 2023 (2 years ago) |
| Document Number: | P05000071647 |
| FEI/EIN Number | 870747597 |
| Address: | 1032 MAR WALT DRIVE, SUITE 220, FORT WALTON BEACH, FL, 32547 |
| Mail Address: | 1032 MAR WALT DRIVE, SUITE 220, FORT WALTON BEACH, FL, 32547 |
| ZIP code: | 32547 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN R. BRENT MD, PA 401(K) PROFIT SHARING PLAN | 2009 | 870747597 | 2010-06-29 | JOHN R. BRENT M.D., P.A. | 2 | |||||||||||||||||||||||||||||||||||||||||
|
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| Administrator’s EIN | 870747597 |
| Plan administrator’s name | JOHN R. BRENT M.D., P.A. |
| Plan administrator’s address | 1032 MAR WALT DRIVE, SUITE 220, FORT WALTON BEACH, FL, 325476661 |
| Administrator’s telephone number | 8507963737 |
Signature of
| Role | Plan administrator |
| Date | 2010-06-29 |
| Name of individual signing | JOHN R. BRENT, MD |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-06-29 |
| Name of individual signing | JOHN R. BRENT, MD |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| BRENT JOHN, R M | Agent | 1032 MAR WALT DR, FORT WALTON BEACH, FL, 32547 |
| Name | Role | Address |
|---|---|---|
| BRENT JOHN R | President | 1032 MAR WALT DRIVE, SUITE 220, FORT WALTON BEACH, FL, 32547 |
| Name | Role | Address |
|---|---|---|
| BRENT JOHN R | Vice President | 1032 MAR WALT DRIVE, SUITE 220, FORT WALTON BEACH, FL, 32547 |
| Name | Role | Address |
|---|---|---|
| BRENT JOHN R | Secretary | 1032 MAR WALT DRIVE, SUITE 220, FORT WALTON BEACH, FL, 32547 |
| Name | Role | Address |
|---|---|---|
| BRENT JOHN R | Treasurer | 1032 MAR WALT DRIVE, SUITE 220, FORT WALTON BEACH, FL, 32547 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000114143 | FLORIDA POT DOCTOR | EXPIRED | 2016-10-19 | 2021-12-31 | No data | 1032 MAR WALT DRIVE 220, FORT WALTON BEACH, FL, 32547 |
| G16000114145 | THE POT DOCTOR | EXPIRED | 2016-10-19 | 2021-12-31 | No data | 1032 MAR WALT DRIVE 220, FORT WALTON BEACH, FL, 32547 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2023-05-30 | No data | No data |
| REINSTATEMENT | 2021-04-02 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| REINSTATEMENT | 2018-02-07 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2018-02-07 | BRENT, JOHN, R M.D. | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-04-13 | 1032 MAR WALT DR, STE 220, FORT WALTON BEACH, FL 32547 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J22000169658 | TERMINATED | 1000000919958 | OKALOOSA | 2022-03-30 | 2032-04-05 | $ 611.69 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, PENSACOLA SERVICE CENTER, 2205 LA VISTA AVE STE B, PENSACOLA FL325048210 |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2023-05-30 |
| ANNUAL REPORT | 2022-07-17 |
| REINSTATEMENT | 2021-04-02 |
| REINSTATEMENT | 2018-02-07 |
| ANNUAL REPORT | 2016-01-20 |
| ANNUAL REPORT | 2015-02-23 |
| ANNUAL REPORT | 2014-01-15 |
| ANNUAL REPORT | 2013-06-12 |
| ANNUAL REPORT | 2012-03-22 |
| ANNUAL REPORT | 2011-02-18 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
