PO# 126324 Trade Name 54156
APPLICATION TO REGISTER A BUSINESS TO BE CONDUCTED UNDER A TRADE NAME STATE OF GEORGIA COUNTY OF LIBERTY The undersigned hereby certifies that it is conducting a business in the City of Hinesville, County of Liberty, State of Georgia under the name of: Liberty Family Dental and that the nature of the business is dental office and that said business is composed of the following: (Limited Liability)Business address: Claxton Family Dental, LLC 43 Ford Avenue Richmond Hill, GA 31324 This affidavit is made in compliance with Georgia Code Annotated Title-10 Chapter-1 Section-490. 54156 7.23.26 RL