| Entity Name: | BASIL D FOSSUM MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 23 Apr 2020 (5 years ago) |
| Date of dissolution: | 27 Sep 2024 (5 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (5 months ago) |
| Document Number: | P20000031618 |
| FEI/EIN Number | 593014004 |
| Address: | 914 B MAR WALT DRIVE, FORT WALTON BEACH, FL, 32547, US |
| Mail Address: | 914 B MAR WALT DRIVE, FORT WALTON BEACH, FL, 32547, US |
| ZIP code: | 32547 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| Name | Role | Address |
|---|---|---|
| FOSSUM BASIL D | Agent | 914 B MAR WALT DRIVE, FORT WALTON BEACH, FL, 32547 |
| Name | Role | Address |
|---|---|---|
| FOSSUM BASIL DMD | Authorized Member | 914 B MAR WALT DRIVE, FORT WALTON BEACH, FL, 32547 |
| AUFDERHEIDE CHRISTINE | Authorized Member | 914 B MAR WALT DRIVE, FORT WALTON BEACH, FL, 32547 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| REINSTATEMENT | 2023-02-15 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2023-02-15 | FOSSUM, BASIL D | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2023-02-15 |
| ANNUAL REPORT | 2021-04-23 |
| Domestic Profit | 2020-04-23 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
