| Plan Name | THOMAS L. LEWELLEN, D.O., P.A. RETIREMENT PLAN |
| Plan identification number | 003 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
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| Company Name: | THOMAS L. LEWELLEN, D.O., P.A. |
| Employer identification number (EIN): | 710539736 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 003 | 2001-01-01 | THOMAS L. LEWELLEN, D.O., P.A. | 2012-07-13 | THOMAS L. LEWELLEN, D.O., P.A. | 2012-07-13 |