FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-292280
1. Florida Dental Political Action Committee
1111 East Tennessee StreetTallahassee, FL 32308
Fax: 850-561-0504
Email: jmoore@floridadental.org
2. Date: 06/22/2007
3. FEC Committee ID #: C00013672 This committee is a Separate Segregated FundAffiliated Committees/Organizations
Florida Dental Association Inc.1111 East Tennessee Street
Tallahassee, Florida 32308
Relationship: Connected
Organization Type: Membership Organization
Custodian of Records:
Jack A. Moore1111 East Tennessee Street
Tallahassee, FL 32308
Title: CFO
Phone # (850) 681-3629
Treasurer:
Dr. Carlos Sanchez2510 SW 27th Avenue
Miami, Florida 33133
Title: Treasurer
Phone # (305) 443-3131
Designated Agent(s):
Douglas Starkey, DMD1120 N Olive Avenue
West Palm Beach, Florida 33401
Title: Chairperson
Phone # (561) 832-3232
Banks or Depositories
People's First Community Bank107 East College Avenue
Tallahassee, Florida 32301
Signed: Dr. Carlos Sanchez
Date Signed: 06/22/2007
Official Committee FAX: 850-561-0504
FORM TEXT