| Entity Name: | MEDICAL ARTS CLINIC, LTD. |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Domestic BCA |
| Status: | Dissolved |
| Date Formed: | 24 Jul 1970 |
| Date of Dissolution: | 27 Jun 2011 |
| Company Number: | CORP_49695241 |
| File Number: | 49695241 |
| Date Status Change: | 27 Jun 2011 |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MEDICAL ARTS CLINIC LTD SIMPLE 401(K) PLAN | 2011 | 370921758 | 2012-02-22 | MEDICAL ARTS CLINIC LTD | 2 | |||||||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 370921758 |
| Plan administrator’s name | MEDICAL ARTS CLINIC LTD |
| Plan administrator’s address | 19 EAST SHAWNEE DRIVE SUITE 2, MURPHYSBORO, IL, 62966 |
| Administrator’s telephone number | 6186842172 |
Signature of
| Role | Plan administrator |
| Date | 2012-02-22 |
| Name of individual signing | DALE W BLAISE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1970-07-24 |
| Business code | 621111 |
| Sponsor’s telephone number | 6186842172 |
| Plan sponsor’s address | 19 EAST SHAWNEE DRIVE SUITE 2, MURPHYSBORO, IL, 62966 |
Plan administrator’s name and address
| Administrator’s EIN | 370921758 |
| Plan administrator’s name | MEDICAL ARTS CLINIC LTD |
| Plan administrator’s address | 19 EAST SHAWNEE DRIVE SUITE 2, MURPHYSBORO, IL, 62966 |
| Administrator’s telephone number | 6186842172 |
Signature of
| Role | Plan administrator |
| Date | 2011-10-04 |
| Name of individual signing | DALE W BLAISE |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2011-10-04 |
| Name of individual signing | DALE W BLAISE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1970-07-24 |
| Business code | 621111 |
| Sponsor’s telephone number | 6186842172 |
| Plan sponsor’s address | 19 EAST SHAWNEE DRIVE SUITE 2, MURPHYSBORO, IL, 62966 |
Plan administrator’s name and address
| Administrator’s EIN | 370921758 |
| Plan administrator’s name | MEDICAL ARTS CLINIC LTD |
| Plan administrator’s address | 19 EAST SHAWNEE DRIVE SUITE 2, MURPHYSBORO, IL, 62966 |
| Administrator’s telephone number | 6186842172 |
Signature of
| Role | Plan administrator |
| Date | 2010-09-21 |
| Name of individual signing | DALE W BLAISE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| DALE BLAISE, 19 EAST SHAWNEE DR STE 2, MURPHYSBORO, 62966, JACKSON | Agent | 1999-05-11 |
| Name and Address | Role |
|---|---|
| DALE BLAISE, 240 TWELVE OAKS DR, MURPHYSBORO 62966 | President |
| License Type | License Number | Status | License Code | License Description | Business Activity | Date Issued | Effective Date | Expiration Date |
|---|---|---|---|---|---|---|---|---|
| MEDICAL CORP | 042000891 | No data | No data | REGISTERED MEDICAL CORPORATION | No data | 1998-01-01 | 2009-10-29 | 2011-01-01 |
| Class | Series | Voting Rights | Authorized Shares | Issued Shares | Par Value |
|---|---|---|---|---|---|
| COMM | No data | Voting Rights | 20000 | 3000000 | No data |
Date of last update: 13 Jan 2025
