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PERIODONTICS & IMPLANTS, LTD.

Headquarter

Company Details

Entity Name: PERIODONTICS & IMPLANTS, LTD.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 09 Feb 1970
Date of Dissolution: 20 Dec 2018
Company Number: CORP_49621361
File Number: 49621361
Type of Business: All Inclusive Purpose
Date Status Change: 20 Dec 2018
Place of Formation: ILLINOIS

Links between entities

Type Company Name Company Number State
Headquarter of PERIODONTICS & IMPLANTS, LTD., IDAHO 552706 IDAHO

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
J6N5F3ZZE246 2024-05-09 4949 HARRISON AVE STE 100, ROCKFORD, IL, 61108, 7947, USA 4949 HARRISON AVENUE STE 100, ROCKFORD, IL, 61108, 7987, USA

Business Information

URL http://www.larsondarby.com
Division Name LARSON AND DARBY INC.
Congressional District 17
State/Country of Incorporation IL, USA
Activation Date 2023-05-12
Initial Registration Date 2001-08-28
Entity Start Date 1962-01-01
Fiscal Year End Close Date Dec 31

Service Classifications

NAICS Codes 541310, 541330

Points of Contacts

Electronic Business
Title PRIMARY POC
Name GERALD BUTTICE
Address 4949 HARRISON AVENUE, ROCKFORD, IL, 61108, 7947, USA
Title ALTERNATE POC
Name GERALD BUTTICE
Address 4949 HARRISON AVENUE, PO BOX 5207, ROCKFORD, IL, 61125, 0207, USA
Government Business
Title PRIMARY POC
Name STEPHEN NELSON
Address 4949 HARRISON AVENUE, ROCKFORD, IL, 61108, 7947, USA
Past Performance Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PERIODONTICS & IMPLANTS, LTD. PROFIT-SHARING AND SAVINGS PLAN AND TRUST 2018 362689985 2019-07-16 PERIODONTICS & IMPLANTS, LTD. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1970-03-02
Business code 621210
Sponsor’s telephone number 8474911880
Plan sponsor’s address 636 CHURCH STREET, EVANSTON, IL, 60201

Signature of

Role Plan administrator
Date 2019-07-16
Name of individual signing RICHARD C. PRENDERGAST
Valid signature Filed with authorized/valid electronic signature
PERIODONTICS & IMPLANTS, LTD. PROFIT-SHARING AND SAVINGS PLAN AND TRUST 2017 362689985 2018-07-13 PERIODONTICS & IMPLANTS, LTD. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1970-03-02
Business code 621210
Sponsor’s telephone number 8474911880
Plan sponsor’s address 636 CHURCH STREET, EVANSTON, IL, 60201

Signature of

Role Plan administrator
Date 2018-07-13
Name of individual signing RICHARD C. PRENDERGAST
Valid signature Filed with authorized/valid electronic signature
PERIODONTICS & IMPLANTS, LTD. PROFIT-SHARING AND SAVINGS PLAN AND TRUST 2016 362689985 2017-07-26 PERIODONTICS & IMPLANTS, LTD. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1970-03-02
Business code 621210
Sponsor’s telephone number 8474911880
Plan sponsor’s address 636 CHURCH STREET, EVANSTON, IL, 60201

Signature of

Role Plan administrator
Date 2017-07-26
Name of individual signing RICHARD C. PRENDERGAST
Valid signature Filed with authorized/valid electronic signature
PERIODONTICS & IMPLANTS, LTD. PROFIT-SHARING AND SAVINGS PLAN AND TRUST 2015 362689985 2016-07-13 PERIODONTICS & IMPLANTS, LTD. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1970-03-02
Business code 621210
Sponsor’s telephone number 8474911880
Plan sponsor’s address 636 CHURCH STREET, EVANSTON, IL, 60201

Signature of

Role Plan administrator
Date 2016-07-13
Name of individual signing RICHARD C. PRENDERGAST
Valid signature Filed with authorized/valid electronic signature
PERIODONTICS & IMPLANTS, LTD. PROFIT-SHARING AND SAVINGS PLAN AND TRUST 2014 362689985 2015-07-09 PERIODONTICS & IMPLANTS, LTD. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1970-03-02
Business code 621210
Sponsor’s telephone number 8474911880
Plan sponsor’s address 636 CHURCH STREET, EVANSTON, IL, 60201

Signature of

Role Plan administrator
Date 2015-07-09
Name of individual signing RICHARD C. PRENDERGAST
Valid signature Filed with authorized/valid electronic signature
PERIODONTICS & IMPLANTS, LTD. PROFIT-SHARING AND SAVINGS PLAN AND TRUST 2013 362689985 2014-07-25 PERIODONTICS & IMPLANTS, LTD. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1970-03-02
Business code 621210
Plan sponsor’s address 636 CHURCH STREET, EVANSTON, IL, 60201

Signature of

Role Plan administrator
Date 2014-07-24
Name of individual signing RICHARD C. PRENDERGAST
Valid signature Filed with authorized/valid electronic signature
PERIODONTICS & IMPLANTS, LTD. PROFIT-SHARING AND SAVINGS PLAN AND TRUST 2012 362689985 2013-09-24 PERIODONTICS & IMPLANTS, LTD. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1970-03-02
Business code 621210
Plan sponsor’s address 636 CHURCH STREET, EVANSTON, IL, 60201

Signature of

Role Plan administrator
Date 2013-09-23
Name of individual signing RICHARD PRENDERGAST
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-09-23
Name of individual signing RICHARD PRENDERGAST
Valid signature Filed with authorized/valid electronic signature
LARSON & DARBY, INC. PROFIT SHARING PLAN 2012 362667316 2013-04-25 LARSON & DARBY, INC. 65
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1972-02-01
Business code 541310
Sponsor’s telephone number 8154840739
Plan sponsor’s address 4949 HARRISON AVENUE, ROCKFORD, IL, 61108

Signature of

Role Plan administrator
Date 2013-04-25
Name of individual signing WILLIAM WALDORF
Valid signature Filed with authorized/valid electronic signature
PERIODONTICS & IMPLANTS, LTD. PROFIT-SHARING AND SAVINGS PLAN AND TRUST 2011 362689985 2012-07-19 PERIODONTICS & IMPLANTS, LTD. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1970-03-02
Business code 621210
Plan sponsor’s address 636 CHURCH STREET, EVANSTON, IL, 60201

Plan administrator’s name and address

Administrator’s EIN 362689985
Plan administrator’s name PERIODONTICS & IMPLANTS, LTD.
Plan administrator’s address 636 CHURCH STREET, EVANSTON, IL, 60201

Signature of

Role Plan administrator
Date 2012-07-17
Name of individual signing RICHARD PRENDERGAST
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-17
Name of individual signing RICHARD PRENDERGAST
Valid signature Filed with authorized/valid electronic signature
LARSON & DARBY, INC. PROFIT SHARING PLAN 2011 362667316 2012-10-11 LARSON & DARBY, INC. 64
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1972-02-01
Business code 541310
Sponsor’s telephone number 8154840739
Plan sponsor’s address 4949 HARRISON AVENUE, ROCKFORD, IL, 61108

Plan administrator’s name and address

Administrator’s EIN 362667316
Plan administrator’s name LARSON & DARBY, INC.
Plan administrator’s address 4949 HARRISON AVENUE, ROCKFORD, IL, 61108
Administrator’s telephone number 8154840739

Signature of

Role Plan administrator
Date 2012-10-11
Name of individual signing WILLIAM WALDORF
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
C T CORPORATION SYSTEM, 208 SO LASALLE ST, SUITE 814, CHICAGO, 60604, COOK-NOT IN CITY OF CHICAGO Agent 2017-01-30

President

Name and Address Role
RICHARD C PRENDERGAST, 636 CHURCH ST #707, EVANSTON 60201 President

License

License Type License Number Status License Code License Description Business Activity Date Issued Effective Date Expiration Date
PROF SERVICE CORP 060000110 No data No data REGISTERED PROFESSIONAL SERVICE CORPORATION No data 1998-01-01 2018-02-21 2019-01-01

Historical Names

Name Change Date
RICHARD C. PRENDERGAST, D.D.S., M.S., PERIODONTICS, LTD. 1995-05-18
RICHARD C. PRENDERGAST, D.D.S., M.S., RONALD C. HARTZER, D.D.S., M.S., PERIODONTICS ASSOC., LTD. 1984-10-15

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 1000 100000 10

Date of last update: 16 Jan 2025

Sources: Illinois Office of the Secretary of State