Notification of Changes for Business Entity
General Information
Business Entity Name:	MMSI, INC.
Incorporation / Formation Date:	2/5/86
FEIN:	411547003
Ohio License Number:	1147199
NPN:	2230691
DBA / Trade Name:	MAYO CLINIC HEALTH SOLUTIONS
State of Domicile:	MN
County:	OLMSTED
Business Address
Address 1:	4001 41ST ST. NW
Address 2:
City:	ROCHESTER
State:	MN
Zip:	55901
Phone:	5075385016
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	4001 41ST ST. NW
Address 2:
City:	ROCHESTER
State:	MN
Zip:	55901
Indicate the type of change you are seeking
Address Change:	NO
Business Entity Name Change:	NO	Old Business Entity Name:
New DBA/Trade Name:	NO	New DBA/Trade Name:
Amend DBA/Trade Name:	NO	Old DBA/Trade Name:
Add/Delete Producers, Members, Owners, Partners, Officers and/or Directors:	YES

Licensed Producers
Name	Title	NPN	Add	Delete	Eff. Date

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date
SHARON GABRIELSON	VICE PRESIDENT	130527323	YES		4/28/17

Title Business Entities Only
1. Is any member, producer, owner, share holder, manager, partner, officer or director currently engaged in deriving income from or affiliated with (other than as a customer) any business or profession other than insurance? (i.e. banking, auto dealer, mortgage company)
2. Has any member, producer, owner, share holder, manager, partner, officer or director currently engaged in deriving income from or affiliated with (other than as a customer) any business or profession other than insurance since the filing of the previous CN-65 or the original application?
3. If the answer to questions #1 or #2 is yes, identify the business or profession and the nature of person's involvement

Submitted By
Submitted By:	BRUCE GOFF
Title:	SECRETARY
Phone Number:	5075387966
Email Address:	GOFF.BRUCE@MAYO.EDU