ALLINA HEALTH COTTAGE GROVE PHARMACY
STATE OF MINNESOTA
SECRETARY OF STATE
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. ASSUMED NAME: Allina Health Cottage Grove Pharmacy
2. PRINCIPAL PLACE OF BUSINESS: 8611 West Point Douglas Road Cottage Grove, MN 55016
3. NAMEHOLDER(S): Allina Health System 2935 Chicago Avenue Mail route 10905 Minneapolis, MN 55407
4. By typing my name, I, the undersigned, 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 Minnesota Statutes section 609.48 as if I had signed this certificate under oath.
SIGNED BY: Elizabeth Truesdell Smith
MAILING ADDRESS: None Provided
EMAIL FOR OFFICIAL NOTICES: firstname.lastname@example.org