| Entity Name: | REVIVAL HEALTH MEDICAL GROUP DE P.A. PC |
| Jurisdiction: | Connecticut |
| Legal type: | Stock |
| Citizenship: | Foreign |
| Status: | Active |
| Sub status: | Admin Dissolution Initiated |
| Date Formed: | 12 Apr 2022 (Companies founded in April 2022) |
| Business ALEI: | 2537367 |
| Annual report due: | 12 Apr 2023 |
| Business address: | 3809 LEGEND TRAIL, GRANBURY, TX, 76049, UNITED STATES |
| Mailing address: | 3809 LEGEND TRAIL, GRANBURY, TX, UNITED STATES, 76049 |
| Place of Formation: | DELAWARE |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| ROBB FUJIOKA | Officer | 1601 N. SEPULVEDA BLVD #103, MANHATTAN BEACH, CA, 90266, United States | 1601 N. SEPULVEDA BLVD #103, MANHATTAN BEACH, CA, 90266, United States |
| BRETT PICCIOTTI, D.O. | Officer | 3809 LEGEND TRAIL, GRANBURY, TX, 76049, United States | 3809 LEGEND TRAIL, GRANBURY, TX, 76049, United States |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| BF-0012749714 | 2024-08-29 | No data | Administrative Dissolution | Notice of Intent to Dissolve/Revoke | No data |
| BF-0010549653 | 2022-04-12 | 2022-04-12 | Business Registration | Certificate of Authority | No data |
Date of last update: 11 Nov 2024
Sources: Connecticut's Official State Website
