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  5. PEDIATRIC & ORTHODONTIC SPECIALISTS, P.C.

PEDIATRIC & ORTHODONTIC SPECIALISTS, P.C.

Company Details

Entity Name: PEDIATRIC & ORTHODONTIC SPECIALISTS, P.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 30 Apr 1982
Date of Dissolution: 10 Sep 2021
Company Number: CORP_52725968
File Number: 52725968
Type of Business: Incorporated under the Medical Corporation Act
Date Status Change: 10 Sep 2021
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. 2019 363167364 2020-12-05 ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. 3
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2014-07-01
Business code 621210
Sponsor’s telephone number 8476346166
Plan sponsor’s address GROVE MEDICAL CENTER, 4160 ILLINOIS 83, SUITE 308, LONG GROVE, IL, 60047

Signature of
Role Plan administrator
Date 2020-12-05
Name of individual signing MARK CANNON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-12-05
Name of individual signing MARK CANNON
Valid signature Filed with authorized/valid electronic signature
ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. CASH BALANCE PLAN 2019 363167364 2021-02-09 ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. 17
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2014-07-01
Business code 621210
Sponsor’s telephone number 8476346166
Plan sponsor’s address GROVE MEDICAL CENTER, 4160 ILLINOIS 83, SUITE 308, LONG GROVE, IL, 60047

Signature of
Role Plan administrator
Date 2021-02-09
Name of individual signing MARK CANNON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-02-09
Name of individual signing MARK CANNON
Valid signature Filed with authorized/valid electronic signature
ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. PROFIT SHARING PLAN 2019 363167364 2020-10-27 ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. 22
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-07-01
Business code 621210
Sponsor’s telephone number 8476346166
Plan sponsor’s address GROVE MEDICAL CENTER, SUITE 308, 4160 ILLINOIS 83, LONG GROVE, IL, 60047

Signature of
Role Plan administrator
Date 2020-10-27
Name of individual signing MARK L. CANNON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-10-27
Name of individual signing MARK L CANNON
Valid signature Filed with authorized/valid electronic signature
ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. PROFIT SHARING PLAN 2018 363167364 2019-11-21 ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. 22
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-07-01
Business code 621210
Sponsor’s telephone number 8476346166
Plan sponsor’s address GROVE MEDICAL CENTER, SUITE 308, 4160 ILLINOIS 83, LONG GROVE, IL, 60047

Signature of
Role Plan administrator
Date 2019-11-11
Name of individual signing MARK L. CANNON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-11-11
Name of individual signing MARK L. CANNON
Valid signature Filed with authorized/valid electronic signature
ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. CASH BALANCE PLAN 2018 363167364 2020-01-10 ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. 16
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2014-07-01
Business code 621210
Sponsor’s telephone number 8476346166
Plan sponsor’s address GROVE MEDICAL CENTER, 4160 ILLINOIS 83, SUITE 308, LONG GROVE, IL, 60047

Signature of
Role Plan administrator
Date 2019-12-27
Name of individual signing MARK CANNON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-12-27
Name of individual signing MARK CANNON
Valid signature Filed with authorized/valid electronic signature
ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. PROFIT SHARING PLAN 2017 363167364 2019-03-22 ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. 21
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-07-01
Business code 621210
Sponsor’s telephone number 8476346166
Plan sponsor’s address GROVE MEDICAL CENTER, SUITE 308, 4160 ILLINOIS 83, LONG GROVE, IL, 60047

Signature of
Role Plan administrator
Date 2019-03-22
Name of individual signing MARK L. CANNON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-03-22
Name of individual signing MARK L. CANNON
Valid signature Filed with authorized/valid electronic signature
ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. CASH BALANCE PLAN 2017 363167364 2019-03-14 ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. 17
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2014-07-01
Business code 621210
Sponsor’s telephone number 8476346166
Plan sponsor’s address GROVE MEDICAL CENTER, 4160 ILLINOIS 83, SUITE 308, LONG GROVE, IL, 60047

Signature of
Role Plan administrator
Date 2019-03-14
Name of individual signing MARK CANNON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-03-14
Name of individual signing MARK CANNON
Valid signature Filed with authorized/valid electronic signature
ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. CASH BALANCE PLAN 2016 363167364 2018-04-12 ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. 13
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2014-07-01
Business code 621210
Sponsor’s telephone number 8476346166
Plan sponsor’s address GROVE MEDICAL CENTER, 4160 ILLINOIS 83, SUITE 308, LONG GROVE, IL, 60047

Signature of
Role Plan administrator
Date 2018-04-12
Name of individual signing MARK CANNON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-04-12
Name of individual signing MARK CANNON
Valid signature Filed with authorized/valid electronic signature
ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. CASH BALANCE PLAN 2016 363167364 2018-04-12 ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. 13
Three-digit plan number (PN) 003
Effective date of plan 2014-07-01
Business code 621210
Sponsor’s telephone number 8476346166
Plan sponsor’s address GROVE MEDICAL CENTER, 4160 ILLINOIS 83, SUITE 308, LONG GROVE, IL, 60047

Signature of
Role Plan administrator
Date 2018-04-12
Name of individual signing MARK CANNON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-04-12
Name of individual signing MARK CANNON
Valid signature Filed with authorized/valid electronic signature
ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. CASH BALANCE PLAN 2016 363167364 2018-04-12 ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. 13
Three-digit plan number (PN) 003
Effective date of plan 2014-07-01
Business code 621210
Sponsor’s telephone number 8476346166
Plan sponsor’s address GROVE MEDICAL CENTER, 4160 ILLINOIS 83, SUITE 308, LONG GROVE, IL, 60047

Signature of
Role Plan administrator
Date 2018-04-12
Name of individual signing MARK CANNON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-04-12
Name of individual signing MARK CANNON
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
DONALD F ENGEL, 311 N ABERDEEN ST STE 200D, CHICAGO, 60607, COOK-NOT IN CITY OF CHICAGO Agent 2019-07-02

President

Name and Address Role
MARK L CANNON, 548 WAYLAND AVE., KENILWORTH, IL, 60043 President

Historical Names

Name Change Date
ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE, LTD. 2020-05-28
MARK L. CANNON, D.D.S., M.S., LTD. 1995-11-13

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 10000 10000000 No data

Related by officers

DONALD F ENGEL, 311 N ABERDEEN ST STE 200D, CHICAGO, 60607, COOK-NOT IN CITY OF CHICAGO

FIRST NATIONAL REALTY, INC.

Related by address

No related companies by address

Date of last update: 23 Jan 2025

Sources: Illinois Office of the Secretary of State

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