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  5. ROBERT A. LARSON, O.D., P.C.

ROBERT A. LARSON, O.D., P.C.

Company Details

Entity Name: ROBERT A. LARSON, O.D., P.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 13 Apr 1993
Company Number: CORP_57269499
File Number: 57269499
Type of Business: Incorporated under the Professional Service Corporation Act
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ROBERT A. LARSON,O.D., P.C. PROFIT SHARING PLAN 2016 363882270 2017-07-07 ROBERT A. LARSON,O.D., P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-05-01
Business code 621320
Sponsor’s telephone number 8154368955
Plan sponsor’s address 15420 S ROUTE 59, PLAINFIELD, IL, 605441984

Signature of
Role Plan administrator
Date 2017-07-07
Name of individual signing MARY LOU LARSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-07
Name of individual signing MARY LOU LARSON
Valid signature Filed with authorized/valid electronic signature
ROBERT A. LARSON, O.D., P.C. PROFIT SHARING PLAN 2015 363882270 2016-06-29 ROBERT A. LARSON, O.D., P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-05-01
Business code 621320
Sponsor’s telephone number 8154368955
Plan sponsor’s address 15420 S ROUTE 59, PLAINFIELD, IL, 605441984

Signature of
Role Plan administrator
Date 2016-06-29
Name of individual signing MARY LOU LARSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-06-29
Name of individual signing MARY LOU LARSON
Valid signature Filed with authorized/valid electronic signature
ROBERT A. LARSON, O.D., P.C. PROFIT SHARING PLAN 2014 363882270 2015-07-23 ROBERT A. LARSON, O.D., P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-05-01
Business code 621320
Sponsor’s telephone number 8154368955
Plan sponsor’s address 15420 S. ROUTE 59, PLAINFIELD, IL, 60544

Signature of
Role Plan administrator
Date 2015-07-23
Name of individual signing MARY LOU LARSON
Valid signature Filed with authorized/valid electronic signature
ROBERT A. LARSON,O.D., P.C. PROFIT SHARING PLAN 2013 363882270 2014-06-30 ROBERT A. LARSON,O.D., P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-05-01
Business code 621320
Sponsor’s telephone number 8154368955
Plan sponsor’s address 15420 S. ROUTE 59, PLAINFIELD, IL, 60544

Signature of
Role Plan administrator
Date 2014-06-30
Name of individual signing MARY LOU LARSON
Valid signature Filed with authorized/valid electronic signature
ROBERT A. LARSON,O.D., P.C. PROFIT SHARING PLAN 2012 363882270 2013-07-22 ROBERT A. LARSON,O.D., P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-05-01
Business code 621320
Sponsor’s telephone number 8154368955
Plan sponsor’s address 15420 S. ROUTE 59, PLAINFIELD, IL, 60544

Signature of
Role Plan administrator
Date 2013-07-22
Name of individual signing MARY LOU LARSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-22
Name of individual signing MARY LOU LARSON
Valid signature Filed with authorized/valid electronic signature
ROBERT A. LARSON,O.D., P.C. PROFIT SHARING PLAN 2011 363882270 2012-07-27 ROBERT A. LARSON, O.D., P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-05-01
Business code 621320
Sponsor’s telephone number 8154368955
Plan sponsor’s address 15420 S. ROUTE 59, PLAINFIELD, IL, 60544

Plan administrator’s name and address
Administrator’s EIN 363882270
Plan administrator’s name ROBERT A. LARSON, O.D., P.C.
Plan administrator’s address 15420 S. ROUTE 59, PLAINFIELD, IL, 60544
Administrator’s telephone number 8154368955

Signature of
Role Plan administrator
Date 2012-07-27
Name of individual signing MARY LOU LARSON
Valid signature Filed with authorized/valid electronic signature
ROBERT A. LARSON, O.D., P.C. PROFIT SHARING PLAN 2010 363882270 2011-07-29 ROBERT A. LARSON, O.D., P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-05-01
Business code 621320
Sponsor’s telephone number 8154368955
Plan sponsor’s address 15420 S. ROUTE 59, PLAINFIELD, IL, 60544

Plan administrator’s name and address
Administrator’s EIN 363882270
Plan administrator’s name ROBERT A. LARSON, O.D., P.C.
Plan administrator’s address 15420 S. ROUTE 59, PLAINFIELD, IL, 60544
Administrator’s telephone number 8154368955

Signature of
Role Plan administrator
Date 2011-07-29
Name of individual signing MARY LOU LARSON
Valid signature Filed with authorized/valid electronic signature
ROBERT A. LARSON, O.D., P.C. PROFIT SHARING PLAN 2009 363882270 2010-10-12 ROBERT A. LARSON, O.D., P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-05-01
Business code 621320
Sponsor’s telephone number 8154368955
Plan sponsor’s address 15420 S. ROUTE 59, PLAINFIELD, IL, 60544

Plan administrator’s name and address
Administrator’s EIN 363882270
Plan administrator’s name ROBERT A. LARSON, O.D., P.C.
Plan administrator’s address 15420 S. ROUTE 59, PLAINFIELD, IL, 60544
Administrator’s telephone number 8154368955

Signature of
Role Plan administrator
Date 2010-10-12
Name of individual signing MARY LOU LARSON
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
ROBERT A LARSON, 15420 S RT 59, PLAINFIELD, 60544, WILL Agent 2004-12-16

Secretary

Name and Address Role
ROBERT A LARSON, 515 WESTRIDGE JOLIET 60431 Secretary

President

Name and Address Role
ROBERT A LARSON, 515 WESTRIDGE JOLIET 60431 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 100000 1360500 No data

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State

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