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  5. ILLINOIS STATE DENTAL SOCIETY

ILLINOIS STATE DENTAL SOCIETY

Company Details

Entity Name: ILLINOIS STATE DENTAL SOCIETY
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 17 Jan 1871
Company Number: CORP_00277436
File Number: 00277436
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ILLINOIS STATE DENTAL SOCIETY EMPLOYEES' 401(K) PROFIT SHARING PLAN 2023 370682986 2024-10-10 ILLINOIS STATE DENTAL SOCIETY 17
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1965-02-01
Business code 813000
Sponsor’s telephone number 2175251406
Plan sponsor’s address 1010 SOUTH SECOND STREET, SPRINGFIELD, IL, 62701

Signature of
Role Plan administrator
Date 2024-10-10
Name of individual signing NICOLAS ATKINSON
Valid signature Filed with authorized/valid electronic signature
ILLINOIS STATE DENTAL SOCIETY MULTIPLE EMPLOYER PLAN 2023 370682986 2024-05-31 ILLINOIS STATE DENTAL SOCIETY 58
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2016-06-01
Business code 541990
Sponsor’s telephone number 2175258872
Plan sponsor’s address 1010 S. 2ND STREET, SPRINGFIELD, IL, 62704

Signature of
Role Plan administrator
Date 2024-05-31
Name of individual signing SUZANNE CHOULJIAN
Valid signature Filed with authorized/valid electronic signature
ILLINOIS STATE DENTAL SOCIETY EMPLOYEES' 401(K) PROFIT SHARING PLAN 2022 370682986 2023-07-07 ILLINOIS STATE DENTAL SOCIETY 22
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1965-02-01
Business code 813000
Sponsor’s telephone number 2175251406
Plan sponsor’s address 1010 S. 2ND STREET, SPRINGFIELD, IL, 62704

Signature of
Role Plan administrator
Date 2023-07-07
Name of individual signing NIC ATKINSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-07-07
Name of individual signing ERIC LARSON
Valid signature Filed with authorized/valid electronic signature
ILLINOIS STATE DENTAL SOCIETY MULTIPLE EMPLOYER PLAN 2022 370682986 2023-05-17 ILLINOIS STATE DENTAL SOCIETY 58
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2016-06-01
Business code 541990
Sponsor’s telephone number 2175258872
Plan sponsor’s address 1010 S. 2ND STREET, SPRINGFIELD, IL, 62704

Signature of
Role Plan administrator
Date 2023-05-17
Name of individual signing SUZANNE CHOULJIAN
Valid signature Filed with authorized/valid electronic signature
ILLINOIS STATE DENTAL SOCIETY EMPLOYEES' 401(K) PROFIT SHARING PLAN 2021 370682986 2022-07-27 ILLINOIS STATE DENTAL SOCIETY 15
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1965-02-01
Business code 541990
Sponsor’s telephone number 2175251406
Plan sponsor’s address 1010 S. 2ND STREET, SPRINGFIELD, IL, 62704

Signature of
Role Plan administrator
Date 2022-07-25
Name of individual signing NIC ATKINSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-07-27
Name of individual signing ERIC LARSON
Valid signature Filed with authorized/valid electronic signature
ILLINOIS STATE DENTAL SOCIETY MULTIPLE EMPLOYER PLAN 2021 370682986 2022-08-22 ILLINOIS STATE DENTAL SOCIETY 61
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2016-06-01
Business code 541990
Sponsor’s telephone number 2175258872
Plan sponsor’s address 1010 S. 2ND STREET, SPRINGFIELD, IL, 62704

Signature of
Role Plan administrator
Date 2022-08-22
Name of individual signing SUZANNE CHOULJIAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-08-22
Name of individual signing SUZANNE CHOULJIAN
Valid signature Filed with authorized/valid electronic signature
ILLINOIS STATE DENTAL SOCIETY MULTIPLE EMPLOYER PLAN 2020 370682986 2021-10-07 ILLINOIS STATE DENTAL SOCIETY 58
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2016-06-01
Business code 541990
Sponsor’s telephone number 2175258872
Plan sponsor’s address 1010 S. 2ND STREET, SPRINGFIELD, IL, 62704

Signature of
Role Plan administrator
Date 2021-10-07
Name of individual signing LARRY EGORT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-10-07
Name of individual signing LARRY EGORT
Valid signature Filed with authorized/valid electronic signature
ILLINOIS STATE DENTAL SOCIETY EMPLOYEES' 401(K) PROFIT SHARING PLAN 2020 370682986 2021-11-08 ILLINOIS STATE DENTAL SOCIETY 15
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1965-02-01
Business code 541990
Sponsor’s telephone number 2175251406
Plan sponsor’s address 1010 SOUTH SECOND STREET, SPRINGFIELD, IL, 62704

Signature of
Role Plan administrator
Date 2021-11-08
Name of individual signing NIC ATKINSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-11-08
Name of individual signing ERIC LARSON
Valid signature Filed with authorized/valid electronic signature
ILLINOIS STATE DENTAL SOCIETY MULTIPLE EMPLOYER PLAN 2019 370682986 2020-10-05 ILLINOIS STATE DENTAL SOCIETY 55
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2016-06-01
Business code 541990
Sponsor’s telephone number 2175258872
Plan sponsor’s address 1010 S. 2ND STREET, SPRINGFIELD, IL, 62704

Signature of
Role Plan administrator
Date 2020-10-05
Name of individual signing LARRY EGORT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-10-05
Name of individual signing LARRY EGORT
Valid signature Filed with authorized/valid electronic signature
ILLINOIS STATE DENTAL SOCIETY EMPLOYEES' 401K PROFIT SHARING PLAN 2019 370682986 2020-11-16 ILLINOIS STATE DENTAL SOCIETY 19
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1965-02-01
Business code 541990
Sponsor’s telephone number 2175251406
Plan sponsor’s address 1010 SOUTH SECOND, SPRINGFIELD, IL, 62704

Signature of
Role Plan administrator
Date 2020-11-16
Name of individual signing ERIC LARSON
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
ERIC M LAISON, 1010 S 2ND ST, SPRINGFIELD, 62704, SANGAMON Agent 2020-01-13

Related by officers

No related officers

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Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State

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