| Name: | ADVANCED FAMILY MEDICAL CLINIC LIBERTY, LLC |
| Legal type: | Kentucky Limited Liability Company |
| Status: | Active |
| Standing: | Good |
| Profit or Non-Profit: | Profit |
| File Date: | 15 May 2017 (8 years ago) |
| Organization Date: | 15 May 2017 (8 years ago) |
| Last Annual Report: | 15 Feb 2025 (2 months ago) |
| Managed By: | Members |
| Organization Number: | 0985562 |
| Industry: | Social Services |
| Number of Employees: | Small (0-19) |
| ZIP code: | 40423 |
| City: | Danville |
| Primary County: | Boyle County |
| Principal Office: | PO BOX 2369, DANVILLE, KY 40423-2369 |
| Place of Formation: | KENTUCKY |
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| YNVGQL7DJUJ9 | 2022-07-10 | 84 HUSTONVILLE ST, LIBERTY, KY, 42539, 3469, USA | PO BOX 2188, LEXINGTON, KY, 40588, USA | |||||||||||||||||||||||||||||||||||||||
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| Congressional District | 01 |
| State/Country of Incorporation | KY, USA |
| Activation Date | 2021-06-15 |
| Initial Registration Date | 2021-06-10 |
| Entity Start Date | 2017-05-15 |
| Fiscal Year End Close Date | Dec 31 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | KHURSHEED SIDDIQUI |
| Role | OWNER/MEDICAL DIRECTOR |
| Address | PO BOX 2188, LEXINGTON, KY, 40588, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | KHURSHEED SIDDIQUI |
| Role | OWNER/MEDICAL DIRECTOR |
| Address | PO BOX 2188, LEXINGTON, KY, 40588, USA |
| Past Performance | Information not Available |
|---|
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ADVANCED FAMILY MEDICAL CLINIC 401(K) PROFIT SHARING PLAN | 2023 | 821533789 | 2024-07-19 | ADVANCED FAMILY MEDICAL CLINIC LIBERTY, LLC | 28 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-07-19 |
| Name of individual signing | KHURSHEED SIDDIQUI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 6067067473 |
| Plan sponsor’s address | 84 HUSTONVILLE STREET, LIBERTY, KY, 42539 |
Signature of
| Role | Plan administrator |
| Date | 2023-07-13 |
| Name of individual signing | KHURSHEED SIDDIQUI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 6067067473 |
| Plan sponsor’s address | 84 HUSTONVILLE STREET, LIBERTY, KY, 42539 |
Signature of
| Role | Plan administrator |
| Date | 2022-09-29 |
| Name of individual signing | KHURSHEED SIDDIQUI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 6067067473 |
| Plan sponsor’s address | 84 HUSTONVILLE STREET, LIBERTY, KY, 42539 |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 6067067473 |
| Plan sponsor’s address | 84 HUSTONVILLE STREET, LIBERTY, KY, 42539 |
| Name | Role |
|---|---|
| Khursheed Siddiqui | Member |
| Sheeba Siddiqui | Member |
| Name | Role |
|---|---|
| KHURSHEED SIDDIQUI | Organizer |
| Name | Role |
|---|---|
| KHURSHEED SIDDIQUI | Registered Agent |
| Name | File Date |
|---|---|
| Annual Report | 2025-02-15 |
| Registered Agent name/address change | 2025-02-15 |
| Annual Report | 2024-03-08 |
| Annual Report | 2023-03-17 |
| Annual Report | 2022-03-06 |
| Registered Agent name/address change | 2022-03-06 |
| Principal Office Address Change | 2021-04-17 |
| Annual Report | 2021-04-17 |
| Annual Report | 2020-07-31 |
| Annual Report | 2019-08-13 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 7674147707 | 2020-05-01 | 0457 | PPP | 300 W BROADWAY ST, DANVILLE, KY, 40422-1408 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sources: Kentucky Secretary of State
