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Affidavit Under Fictitious Name Statute
STATE OF RORIDA
SS.
COUNTY OF ST. LUCiE
The undersig~ed, under oath, says: That he or she is engaged in a business enterprise uncler the ,
fictitious name of ______H. _C._ McDERMID, M. D.
located at 702 North 7th Street
y Fort_Pierce`-----------------. St. tucie County, Flwida
in the Ci of
Those interested in said enterprise, and the extent of the interest of each, is as follows: -
H. C. McDERMID, M.D., P.A. 100$
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Proof of publication of this intention to register, is filed herewith, pursuant to the provisions of
Chapter 2Q953, Laws of 1941. ~
H.C. cDermid, M.D., P.A.
By---- ---------w, -
Its President
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Sworn to and subsuibed before me this day of July____~ 19_ 72_.
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ROGER POITRAS ~G~~-~_.~'~~`""'~-
CLERK CIRCUR COURT Notary Public
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D.C. My Commission expir~~__~~-~~_
BY - ~
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