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  5. ORAL SURGEONS OF SOUTHERN ILLINOIS, P.C.

ORAL SURGEONS OF SOUTHERN ILLINOIS, P.C.

Company Details

Entity Name: ORAL SURGEONS OF SOUTHERN ILLINOIS, P.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 28 Nov 2000
Company Number: CORP_61347402
File Number: 61347402
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
ORAL SURGEONS OF SOUTHERN ILLINOIS, PC 401K PROFIT SHARING PLAN 2023 371404751 2024-06-25 ORAL SURGEONS OF SOUTHERN ILLINOIS, P.C. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 6186281800
Plan sponsor’s address 741 WEST STATE STREET, SUITE 3, OFALLON, IL, 62269

Signature of
Role Plan administrator
Date 2024-06-25
Name of individual signing DR. TODD SCHULTZ
Valid signature Filed with authorized/valid electronic signature
ORAL SURGEONS OF SOUTHERN ILLINOIS, PC 401K PROFIT SHARING PLAN 2022 371404751 2023-09-05 ORAL SURGEONS OF SOUTHERN ILLINOIS, P.C. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 6186281800
Plan sponsor’s address 741 WEST STATE STREET, SUITE 3, OFALLON, IL, 62269

Signature of
Role Plan administrator
Date 2023-09-05
Name of individual signing DR. TODD SCHULTZ
Valid signature Filed with authorized/valid electronic signature
ORAL SURGEONS OF SOUTHERN ILLINOIS, PC 401K PROFIT SHARING PLAN 2021 371404751 2022-08-11 ORAL SURGEONS OF SOUTHERN ILLINOIS, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 6186281800
Plan sponsor’s address 741 WEST STATE STREET, SUITE 3, OFALLON, IL, 622691971

Signature of
Role Plan administrator
Date 2022-08-11
Name of individual signing DR. TODD SCHULTZ
Valid signature Filed with authorized/valid electronic signature
ORAL SURGEONS OF SOUTHERN ILLINOIS, PC 401K PROFIT SHARING PLAN 2020 371404751 2021-07-27 ORAL SURGEONS OF SOUTHERN ILLINOIS, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 6186281800
Plan sponsor’s address 741 WEST STATE STREET, SUITE 3, OFALLON, IL, 622691971

Signature of
Role Plan administrator
Date 2021-07-27
Name of individual signing JOHN LEIB
Valid signature Filed with authorized/valid electronic signature
ORAL SURGEONS OF SOUTHERN ILLINOIS, PC 401K PROFIT SHARING PLAN 2019 371404751 2020-06-11 ORAL SURGEONS OF SOUTHERN ILLINOIS, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 6186281800
Plan sponsor’s address 741 WEST STATE STREET, SUITE 3, OFALLON, IL, 622691971

Signature of
Role Plan administrator
Date 2020-06-11
Name of individual signing JOHN LEIB
Valid signature Filed with authorized/valid electronic signature
ORAL SURGEONS OF SOUTHERN ILLINOIS, PC 401K PROFIT SHARING PLAN 2018 371404751 2019-05-02 ORAL SURGEONS OF SOUTHERN ILLINOIS, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 6186281800
Plan sponsor’s address 741 WEST STATE STREET, SUITE 3, OFALLON, IL, 622691971

Signature of
Role Plan administrator
Date 2019-05-02
Name of individual signing JOHN LEIB
Valid signature Filed with authorized/valid electronic signature
ORAL SURGEONS OF SOUTHERN ILLINOIS, PC 401K PROFIT SHARING PLAN 2017 371404751 2018-06-19 ORAL SURGEONS OF SOUTHERN ILLINOIS, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 6186281800
Plan sponsor’s address 741 WEST STATE STREET, SUITE 3, OFALLON, IL, 622691971

Signature of
Role Plan administrator
Date 2018-06-19
Name of individual signing JOHN LEIB
Valid signature Filed with authorized/valid electronic signature
ORAL SURGEONS OF SOUTHERN ILLINOIS, PC 401K PROFIT SHARING PLAN 2016 371404751 2017-07-21 ORAL SURGEONS OF SOUTHERN ILLINOIS, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 6186281800
Plan sponsor’s address 741 WEST STATE STREET, SUITE 3, OFALLON, IL, 622691971

Signature of
Role Plan administrator
Date 2017-07-21
Name of individual signing JOHN LEIB
Valid signature Filed with authorized/valid electronic signature
ORAL SURGEONS OF SOUTHERN ILLINOIS, PC 401K PROFIT SHARING PLAN 2015 371404751 2016-08-19 ORAL SURGEONS OF SOUTHERN ILLINOIS, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 6186281800
Plan sponsor’s address 741 WEST STATE STREET, SUITE 3, OFALLON, IL, 622691971

Signature of
Role Plan administrator
Date 2016-08-19
Name of individual signing JOHN LEIB
Valid signature Filed with authorized/valid electronic signature
ORAL SURGEONS OF SOUTHERN ILLINOIS, PC 401K PROFIT SHARING PLAN 2014 371404751 2015-10-12 ORAL SURGEONS OF SOUTHERN ILLINOIS, P.C. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 6186281800
Plan sponsor’s address 741 WEST STATE STREET, SUITE 3, OFALLON, IL, 622691971

Signature of
Role Plan administrator
Date 2015-10-12
Name of individual signing JOHN LEIB
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
FLYNN GUYMON & GARAVALIA LLC, 300 W MAIN ST STE 4, BELLEVILLE, 62220, ST. CLAIR Agent 2014-05-23

President

Name and Address Role
TODD A SCHULTZ 741 WEST STATE ST STE 3 OFALLEN IL 62269 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 1000 100000 No data

Related by officers

FLYNN GUYMON & GARAVALIA LLC, 300 W MAIN ST STE 4, BELLEVILLE, 62220, ST. CLAIR

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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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