| Name: | Lifestyle Medicine of Idaho PLLC |
| Jurisdiction: | Idaho |
| Legal type: | Limited Liability Company (D) |
| Status: | Active-Existing |
| Date of registration: | 24 Apr 2022 (3 years ago) |
| Financial Date End: | 30 Apr 2025 |
| Entity Number: | 4714434 |
| Place of Formation: | IDAHO |
| File Number: | 818724 |
| ZIP code: | 83669 |
| County: | Ada County |
| Principal Address: | 25374 W. DEEP CANYON DR STAR, ID 83669 |
| Mailing Address: | 25374 W DEEP CANYON DR STAR, ID 83669-5705 |
| Name | Role | Address |
|---|---|---|
| Stevan Evans | Agent | 22136 RIO VISTA DR, CALDWELL, ID 83607 |
| Name | Role | Address | Appointed On |
|---|---|---|---|
| Bradley C Wrobel | Manager | 25374 W. DEEP CANYON DR., STAR, ID 83669 | 2023-03-21 |
| Name | Role | Address | Appointed On |
|---|---|---|---|
| Amanda J Smith | Member | 25374 W DEEP CANYON DR, STAR, ID 83669 | 2024-04-24 |
| Filing Name | Filing Number | Filing date |
|---|---|---|
| Annual Report | 0005702626 | 2024-04-24 |
| Annual Report | 0005163648 | 2023-03-21 |
| Initial Filing | 0004714434 | 2022-04-24 |
Date of last update: 06 Jan 2025
Sources: Idaho Secretary of State
