| Name: | PRO-FORM SPORTS MEDICINE, P.C. |
| Jurisdiction: | New York |
| Legal type: | DOMESTIC PROFESSIONAL SERVICE CORPORATION |
| Status: | Inactive |
| Date of registration: | 13 Mar 1987 (38 years ago) |
| Entity Number: | 1152842 |
| County: | Suffolk |
| Date of dissolution: | 19 Jul 2007 |
| Place of Formation: | New York |
| Principal Address: | 290 EAST MAIN STREET, SMITHTOWN, NY, United States, 11787 |
| Principal Address ZIP Code: | 11787 |
| Address: | 290 E MAIN ST, STE 700, SMITHTOWN, NY, United States, 11787 |
| Address ZIP Code: | 11787 |
Shares Details
Shares issued 200
Share Par Value 0
Type NO PAR VALUE
| Name | Role | Address |
|---|---|---|
| ENRICO S. MANGO, M.D. | Chief Executive Officer | 290 EAST MAIN STREET, SMITHTOWN, NY, United States, 11787 |
| Name | Role | Address |
|---|---|---|
| THE CORPORATION | DOS Process Agent | 290 E MAIN ST, STE 700, SMITHTOWN, NY, United States, 11787 |
| Start date | End date | Type | Value |
|---|---|---|---|
| 1993-06-24 | 1997-04-14 | Address | 256-08 NORTH COUNTRY ROAD, ST. JAMES, NY, 11780, USA (Type of address: Service of Process) |
| 1987-03-13 | 1993-06-24 | Address | 290 EAST MAIN ST, SUITE 800, SMITHTOWN, NY, 11787, USA (Type of address: Service of Process) |
| Filing Number | Date Filed | Type | Effective Date |
|---|---|---|---|
| 070719000197 | 2007-07-19 | CERTIFICATE OF DISSOLUTION | 2007-07-19 |
| 010418002796 | 2001-04-18 | BIENNIAL STATEMENT | 2001-03-01 |
| 990428002273 | 1999-04-28 | BIENNIAL STATEMENT | 1999-03-01 |
| 970414002280 | 1997-04-14 | BIENNIAL STATEMENT | 1997-03-01 |
| 940422002276 | 1994-04-22 | BIENNIAL STATEMENT | 1994-03-01 |
| 930624002900 | 1993-06-24 | BIENNIAL STATEMENT | 1993-03-01 |
| B469656-7 | 1987-03-13 | CERTIFICATE OF INCORPORATION | 1987-03-13 |
Date of last update: 15 Nov 2024
Sources: New York Secretary of State
