| | Organization Number | 0296201 |
| | Name | JAMES R. CICCHIELLO, SR, MD., P.S.C. |
| | Profit or Non-Profit | P - Profit |
| | Company Type | KPS - Kentucky Professional Services Corp |
| | Status | I - Inactive |
| | Standing | B - Bad |
| | State | KY |
| | Organization Date | 1/31/1992 |
| | Last Annual Report | 10/4/1996 |
| | Principal Office | 9131 FERN CREEK RD
LOUISVILLE, KY 40291 |
| | Registered Agent | JAMES R. CICCHIELLO, SR, MD
PRESTON MEDICAL CTR., STE. 106
7926 PRESTON HWY.
LOUISVILLE, KY 402193837 |
| | Common No Par Shares | 1000 |
