Company Details
| Name: |
JAN DEBLIECK,M.D, P.A. |
| Jurisdiction: |
Idaho |
| Legal type: |
Professional Service Corporation (D) |
| Status: |
Active-Good Standing
|
| Date of registration: |
29 Apr 2005 (20 years ago)
|
| Financial Date End: |
30 Apr 2026 |
| Entity Number: |
486251 |
| Place of Formation: |
IDAHO |
| File Number: |
486251 |
| Mailing Address: |
STE 100 13176 W PERSIMMON LN BOISE, ID 83713-5015 |
Agent
| Name |
Role |
Address |
|
JAN DEBLIECK MD
|
Agent
|
13176 W PERSMIMMON LN, BOISE, ID 83713
|
President
| Name |
Role |
Address |
Appointed On |
Resigned On |
|
JAN DEBLIECK MD
|
President
|
13176 W PERSIMMON LN, BOISE, ID 83713
|
2024-03-14
|
2024-03-14
|
Treasurer
| Name |
Role |
Address |
Appointed On |
Resigned On |
|
JAN DEBLIECK MD
|
Treasurer
|
13176 W PERSIMMON LN, BOISE, ID 83713
|
2024-03-14
|
2024-03-14
|
Secretary
| Name |
Role |
Address |
Appointed On |
|
JAN DEBLIECK MD
|
Secretary
|
13176 W PERSIMMON LN, BOISE, ID 83713
|
2021-03-24
|
National Provider Identifier
Authorized Person:
Name:
DR. JENNIFER DEBLIECK
Taxonomy:
Selected Taxonomy:
207N00000X - Dermatology Physician
Contacts:
Paycheck Protection Program
Date Approved:
2020-04-12
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
51500
Current Approval Amount:
51542.5
Ethnicity:
Unknown/NotStated
Forgiveness Amount:
51978.85
This company hasn't received any reviews.
Date of last update: 02 Jul 2025
Sources:
Idaho Secretary of State
