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  5. THOMAS BEZOUSKA D.D.S., P.C.

THOMAS BEZOUSKA D.D.S., P.C.

Company Details

Entity Name: THOMAS BEZOUSKA D.D.S., P.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 27 Jul 1999
Date of Dissolution: 09 Dec 2022
Company Number: CORP_60599599
File Number: 60599599
Type of Business: Incorporated under the Professional Service Corporation Act
Date Status Change: 09 Dec 2022
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
WASHINGTON DENTAL EXCELLENCE 401(K) PLAN 2020 364309137 2021-07-26 WASHINGTON DENTAL EXCELLENCE 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8476234888
Plan sponsor’s address 3930 W WASHINGTON STREET, GURNEE, IL, 60031

Signature of
Role Plan administrator
Date 2021-07-26
Name of individual signing THOMAS BEZOUSKA
Valid signature Filed with authorized/valid electronic signature
WASHINGTON DENTAL EXCELLENCE 401(K) PLAN 2020 364309137 2021-12-14 WASHINGTON DENTAL EXCELLENCE 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8476234888
Plan sponsor’s address 3930 W WASHINGTON STREET, GURNEE, IL, 60031
WASHINGTON DENTAL EXCELLENCE 401(K) PLAN 2019 364309137 2020-09-18 WASHINGTON DENTAL EXCELLENCE 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8476234888
Plan sponsor’s address 3930 W WASHINGTON STREET, GURNEE, IL, 60031

Signature of
Role Plan administrator
Date 2020-09-18
Name of individual signing THOMAS BEZOUSKA
Valid signature Filed with authorized/valid electronic signature
WASHINGTON DENTAL EXCELLENCE CASH BALANCE PLAN 2018 364309137 2019-10-09 WASHINGTON DENTAL EXCELLENCE 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 8476234888
Plan sponsor’s address 3930 W WASHINGTON STREET, GURNEE, IL, 60031

Signature of
Role Plan administrator
Date 2019-10-09
Name of individual signing THOMAS BEZOUSKA
Valid signature Filed with authorized/valid electronic signature
WASHINGTON DENTAL EXCELLENCE 401(K) PLAN 2018 364309137 2019-07-23 WASHINGTON DENTAL EXCELLENCE 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8476234888
Plan sponsor’s address 3930 W WASHINGTON STREET, GURNEE, IL, 60031

Signature of
Role Plan administrator
Date 2019-07-23
Name of individual signing THOMAS BEZOUSKA
Valid signature Filed with authorized/valid electronic signature
WASHINGTON DENTAL EXCELLENCE CASH BALANCE PLAN 2017 364309137 2018-07-16 WASHINGTON DENTAL EXCELLENCE 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 8476234888
Plan sponsor’s address 3930 W WASHINGTON STREET, GURNEE, IL, 60031

Signature of
Role Plan administrator
Date 2018-07-16
Name of individual signing THOMAS BEZOUSKA
Valid signature Filed with authorized/valid electronic signature
WASHINGTON DENTAL EXCELLENCE 401(K) PLAN 2017 364309137 2018-07-13 WASHINGTON DENTAL EXCELLENCE 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8476234888
Plan sponsor’s address 3930 W WASHINGTON STREET, GURNEE, IL, 60031

Signature of
Role Plan administrator
Date 2018-07-13
Name of individual signing THOMAS BEZOUSKA
Valid signature Filed with authorized/valid electronic signature
WASHINGTON DENTAL EXCELLENCE CASH BALANCE PLAN 2016 364309137 2017-07-18 WASHINGTON DENTAL EXCELLENCE 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 8476234888
Plan sponsor’s address 3930 W WASHINGTON STREET, GURNEE, IL, 60031

Signature of
Role Plan administrator
Date 2017-07-18
Name of individual signing THOMAS BEZOUSKA
Valid signature Filed with authorized/valid electronic signature
WASHINGTON DENTAL EXCELLENCE 401(K) PLAN 2016 364309137 2017-03-17 WASHINGTON DENTAL EXCELLENCE 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8476234888
Plan sponsor’s address 3930 W WASHINGTON STREET, GURNEE, IL, 60031

Signature of
Role Plan administrator
Date 2017-03-17
Name of individual signing THOMAS BEZOUSKA
Valid signature Filed with authorized/valid electronic signature
WASHINGTON DENTAL EXCELLENCE CASH BALANCE PLAN 2015 364309137 2016-08-08 WASHINGTON DENTAL EXCELLENCE 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 8476234888
Plan sponsor’s address 3930 W WASHINGTON STREET, GURNEE, IL, 60031

Signature of
Role Plan administrator
Date 2016-08-08
Name of individual signing THOMAS BEZOUSKA
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
THOMAS B HOOD, 501 N RIVERSIDE DR STE 204, GURNEE, 60031, LAKE Agent 2012-06-27

President

Name and Address Role
THOMAS BEZOUSKA 18531 BROOK, GRAYSLAKE, ILLINOIS 60030 President

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
WASHINGTON DENTAL EXCELLENCE No data 2015-10-07 2022-12-01 Involuntary Cancellation No data

Shares

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

Related by officers

THOMAS B HOOD, 501 N RIVERSIDE DR STE 204, GURNEE, 60031, LAKE

ERNIE PETERSON PLUMBING, INC. FRANK'S AUTO CENTER, INC. WAUKEGAN GLASS, INC. MW GOOD INC. LAKESIDE GLASS & MIRROR, INC. OFFICE TRAINING SERVICES, INC. GURNEE COUNSELING CENTER, LTD. QUALITY FOOD BROKERS, INC. JOHN'S REMODELING INC. SARDIS MEDIA, LTD.

Related by address

No related companies by address

Date of last update: 27 Jan 2025

Sources: Illinois Office of the Secretary of State

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