| Entity Name: | DERMATOLOGY PHYSICIANS & SURGEONS, LTD. |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Domestic BCA |
| Status: | Dissolved |
| Date Formed: | 28 May 1981 |
| Date of Dissolution: | 11 Oct 2019 |
| Company Number: | CORP_52402239 |
| File Number: | 52402239 |
| Date Status Change: | 11 Oct 2019 |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DERMATOLOGY PHYSICIANS & SURGEONS, LTD. DEFINED BENEFIT PENSION PLAN AND TRUST | 2009 | 363124260 | 2010-11-15 | DERMATOLOGY PHYSICIANS & SURGEONS, LTD. | 25 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 363124260 |
| Plan administrator’s name | DERMATOLOGY PHYSICIANS & SURGEONS, LTD. |
| Plan administrator’s address | 738 W NORTHWEST HWY, BARRINGTON, IL, 600102640 |
| Administrator’s telephone number | 8473825111 |
Signature of
| Role | Plan administrator |
| Date | 2010-11-15 |
| Name of individual signing | DAVID P. VAN DAM, M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| DAVID P VAN DAM, 738 W NORTHWEST HWY, BARRINGTON, 60010, LAKE | Agent | 2009-05-04 |
| Name and Address | Role |
|---|---|
| DAVID P VAN DAM 533 S GROVE AVENUE BARRINGTON 60010 | President |
| License Type | License Number | Status | License Code | License Description | Business Activity | Date Issued | Effective Date | Expiration Date |
|---|---|---|---|---|---|---|---|---|
| MEDICAL CORP | 042618596 | No data | No data | REGISTERED MEDICAL CORPORATION | No data | 2005-07-13 | 2018-12-21 | 2022-01-01 |
| MEDICAL CORP | 042618568 | No data | No data | REGISTERED MEDICAL CORPORATION | No data | 2005-06-13 | 2005-06-13 | 2006-01-01 |
| Name | Type | Effective Date | Cancellation Date | Cancellation Type | Last Renewal Date |
|---|---|---|---|---|---|
| VAN DAM DERMATOLOGY AND LASER CENTER, LTD. | No data | 2007-05-03 | 2019-10-01 | Involuntary Cancellation | No data |
| VAN DAM DERMATOLOGY, LTD. | No data | 2004-07-13 | 2010-03-30 | Expired | No data |
| Name | Change Date |
|---|---|
| DERMATOLOGY ASSOCIATES OF CRYSTAL LAKE/BARRINGTON, S.C. | 1999-09-21 |
| DAVID P. VAN DAM, M.D. S.C. | 1985-10-23 |
| Class | Series | Voting Rights | Authorized Shares | Issued Shares | Par Value |
|---|---|---|---|---|---|
| COMM | No data | Voting Rights | 1000 | 200000 | No data |
Date of last update: 13 Jan 2025
