| Name | ERIN POLUKOSHKO, OD, PC C/O PRESIDENT |
|---|---|
| Address | 6633 SOUTH VIRGINIA ST |
| City | RENO |
| State | NV |
| Zip | 89511 |
| Mailing Address | PO BOX 18822 |
| Mailing Address 2 | PO BOX 18822 |
| Mailing City | RENO |
| Mailing State | NV |
| Mailing Zip | 89511 |
| Agent Type | Noncommercial Registered Agent |
| Company | ERIN POLUKOSHKO, OD, PC |
|---|---|
| Entity Number | C28339-2003 |
| NV Business ID | NV20031517005 |