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  5. UROLOGIC SURGERY ASSOCIATES, S.C.

UROLOGIC SURGERY ASSOCIATES, S.C.

Company Details

Entity Name: UROLOGIC SURGERY ASSOCIATES, S.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 18 Dec 1996
Date of Dissolution: 13 May 2016
Company Number: CORP_59172913
File Number: 59172913
Type of Business: Incorporated under the Medical Corporation Act
Date Status Change: 13 May 2016
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
UROLOGIC SURGERY ASSOCIATES, S.C. 401(K) PROFIT-SHARING PLAN & TRUST 2012 364121826 2013-05-28 UROLOGIC SURGERY ASSOCIATES, S.C. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621111
Sponsor’s telephone number 3096619999
Plan sponsor’s address 1414 WOODBINE ROAD, BLOOMINGTON, IL, 61704

Signature of
Role Plan administrator
Date 2013-05-28
Name of individual signing SCOTT MORGAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-05-28
Name of individual signing SCOTT MORGAN
Valid signature Filed with authorized/valid electronic signature
UROLOGIC SURGERY ASSOCIATES, S.C. 401(K) PROFIT-SHARING PLAN & TRUST 2012 364121826 2013-08-20 UROLOGIC SURGERY ASSOCIATES, S.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621111
Sponsor’s telephone number 3096619999
Plan sponsor’s address 1414 WOODBINE ROAD, BLOOMINGTON, IL, 61704

Signature of
Role Plan administrator
Date 2013-08-20
Name of individual signing SCOTT MORGAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-08-20
Name of individual signing SCOTT MORGAN
Valid signature Filed with authorized/valid electronic signature
UROLOGIC SURGERY ASSOCIATES, S.C. 401(K) PROFIT-SHARING PLAN & TRUST 2011 364121826 2012-06-25 UROLOGIC SURGERY ASSOCIATES, S.C. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621111
Sponsor’s telephone number 3096619999
Plan sponsor’s address 1414 WOODBINE ROAD, BLOOMINGTON, IL, 61704

Plan administrator’s name and address
Administrator’s EIN 364121826
Plan administrator’s name UROLOGIC SURGERY ASSOCIATES, S.C.
Plan administrator’s address 1414 WOODBINE ROAD, BLOOMINGTON, IL, 61704
Administrator’s telephone number 3096619999

Signature of
Role Plan administrator
Date 2012-06-25
Name of individual signing SCOTT MORGAN
Valid signature Filed with authorized/valid electronic signature
UROLOGIC SURGERY ASSOCIATES, S.C. 401(K) PROFIT-SHARING PLAN & TRUST 2010 364121826 2011-05-26 UROLOGIC SURGERY ASSOCIATES, S.C. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621111
Sponsor’s telephone number 3098884000
Plan sponsor’s address 2005 JACOBSSEN DRIVE, SUITE A, NORMAL, IL, 61761

Plan administrator’s name and address
Administrator’s EIN 364121826
Plan administrator’s name UROLOGIC SURGERY ASSOCIATES, S.C.
Plan administrator’s address 2005 JACOBSSEN DRIVE, SUITE A, NORMAL, IL, 61761
Administrator’s telephone number 3098884000

Signature of
Role Plan administrator
Date 2011-05-26
Name of individual signing SCOTT MORGAN
Valid signature Filed with authorized/valid electronic signature
UROLOGIC SURGERY ASSOCIATES, S.C. 401(K) PROFIT-SHARING PLAN & TRUST 2009 364121826 2010-07-26 UROLOGIC SURGERY ASSOCIATES, S.C. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621111
Sponsor’s telephone number 3098884000
Plan sponsor’s address 2005 JACOBSSEN DRIVE, SUITE A, NORMAL, IL, 61761

Plan administrator’s name and address
Administrator’s EIN 364121826
Plan administrator’s name UROLOGIC SURGERY ASSOCIATES, S.C.
Plan administrator’s address 2005 JACOBSSEN DRIVE, SUITE A, NORMAL, IL, 61761
Administrator’s telephone number 3098884000

Signature of
Role Plan administrator
Date 2010-07-26
Name of individual signing SCOTT MORGAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
A CLAY COX, 202 N CENTER ST, BLOOMINGTON, 61701, MC LEAN Agent 1998-11-19

President

Name and Address Role
MARIANO V TOLENTINO JR 1414 WOODBINE RD., BLOOMINGTON 61704 President

Historical Names

Name Change Date
MARIANO V. TOLENTINO, JR., M.D., S.C. 1998-07-16

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 10000 1000000 No data

Related by officers

A CLAY COX, 202 N CENTER ST, BLOOMINGTON, 61701, MC LEAN

DAVE'S SUPER MARKET, INC. WEST SIDE LIQUORS, INC. ASSOCIATED DENTISTS, P.C. BLOOMINGTON RADIOLOGY, S.C. MANNA-PAK, LLC WATERSHED FOODS, LLC ZOZZARO GROUP, PLLC AQUARANCH PRODUCE, LLC TODD FARMS, INC. BJJ CORP.

Related by address

No related companies by address

Date of last update: 16 Jan 2025

Sources: Illinois Office of the Secretary of State

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