| Entity Name: | LARRY R. BRAZLEY, M.D., LTD. |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Domestic BCA |
| Status: | Dissolved |
| Date Formed: | 03 Dec 1981 |
| Date of Dissolution: | 10 May 2024 |
| Company Number: | CORP_52587743 |
| File Number: | 52587743 |
| Date Status Change: | 10 May 2024 |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LARRY R. BRAZLEY, M.D., LTD | 2011 | 363159168 | 2012-05-25 | LARRY R. BRAZLEY,M.D., LTD | 1 | |||||||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 363159168 |
| Plan administrator’s name | LARRY R. BRAZLEY,M.D., LTD |
| Plan administrator’s address | 5230 S UNIVERSITY AVE UNIT D, CHICAGO, IL, 60615 |
| Administrator’s telephone number | 2197910248 |
Signature of
| Role | Plan administrator |
| Date | 2012-05-25 |
| Name of individual signing | LARRY R. BRAZLEY |
| Valid signature | Filed with incorrect/unrecognized electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1994-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2197910248 |
| Plan sponsor’s address | 5230 S UNIVERSITY AVE UNIT D, CHICAGO, IL, 60615 |
Plan administrator’s name and address
| Administrator’s EIN | 363159168 |
| Plan administrator’s name | LARRY R. BRAZLEY,M.D., LTD |
| Plan administrator’s address | 5230 S UNIVERSITY AVE UNIT D, CHICAGO, IL, 60615 |
| Administrator’s telephone number | 2197910248 |
Signature of
| Role | Plan administrator |
| Date | 2012-05-28 |
| Name of individual signing | LARRY R. BRAZLEY |
| Valid signature | Filed with incorrect/unrecognized electronic signature |
| Role | Employer/plan sponsor |
| Date | 2012-05-28 |
| Name of individual signing | LARRY R. BRAZLEY |
| Valid signature | Filed with incorrect/unrecognized electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| ALAN M SIMON, 180 NORTH STETSON AVE 3500, CHICAGO, 60601, COOK-NOT IN CITY OF CHICAGO | Agent | 2011-03-04 |
| Name and Address | Role |
|---|---|
| LARRY R BRAZLEY MD, 5230 S UNIVERSITY AVE CHICAGO IL 60615 | President |
| Class | Series | Voting Rights | Authorized Shares | Issued Shares | Par Value |
|---|---|---|---|---|---|
| COMMON | No data | Voting Rights | 1000 | 550000 | No data |
Date of last update: 16 Jan 2025
