| Name | BRIAN JEPSEN |
|---|---|
| Address | 3824 GRASSY CANYON STREET |
| City | LAS VEGAS |
| State | NV |
| Zip | 89129 |
| Mailing Address | 3824 GRASSY CANYON STREET |
| Mailing Address 2 | 3824 GRASSY CANYON STREET |
| Mailing City | LAS VEGAS |
| Mailing State | NV |
| Mailing Zip | 89129 |
| Agent Type | Noncommercial Registered Agent |
| Company | QUIXOTIC WEIGHT LOSS SURGERY EDUCATIONAL FOUNDATION |
|---|---|
| Entity Number | E0171372008-1 |
| NV Business ID | NV20081618565 |