Certificate of Assumed Name – Life Clinic Medical



Minnesota Statutes Chapter 333

The filing of an assumed name does not provide a user with exclusive rights to that name. The filing is required for consumer protection in order to enable consumers to be able to identify the true owner of a business.

1. State the exact assumed name under which the business is or will be conducted: LCMedical

2. State the address of the principal place of business. A complete street address or rural route and rural route box number is required; the address cannot be a P.O. Box: 2902 Corporate Place, Chanhassen, MN 55317

List the name and complete street address of all persons conducting business under the above Assumed Name OR if an entity, provide the legal corporate, LLC, or Limited Partnership name and registered office address: Life Clinic Medical, P.A., 2902 Corporate Place, Chanhassen, MN 55317

I certify that I am signing this document as the person whose signature is required, or as agent of the person(s) whose signature would be required who has authorized me to sign this document on his/her behalf, or in both capacities. I further certify that I have completed all required fields, and that the information in this document is true  and correct and in compliance with the applicable chapter of Minnesota Statutes. I understand that by signing this document I am subject to the penalties of perjury as set forth in Section 609.48 as if I had signed this document under oath.


/s/Kambiz Farbakhsh


Dated 6-21-13


Cheyene Moseley

Contact Person

323-962-8600 Ext 7625


(Published in the Carver County News Aug. 22 and 29, 2013)