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  5. ADS OF LAKE COUNTY, LTD.

ADS OF LAKE COUNTY, LTD.

Company Details

Entity Name: ADS OF LAKE COUNTY, LTD.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 25 Mar 2002
Date of Dissolution: 23 Mar 2022
Company Number: CORP_62110805
File Number: 62110805
Type of Business: Incorporated under the Medical Corporation Act
Date Status Change: 23 Mar 2022
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AFFILIATED DENTAL SPECIALISTS, LTD PROFIT SHARING PLAN 2020 363096708 2021-11-14 AFFILIATED DENTAL SPECIALISTS, LTD. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-08-01
Business code 621210
Sponsor’s telephone number 8473676068
Plan sponsor’s address ONE EAST PHILLIP RD., SUITE 102, VERNON HILLS, IL, 60061

Signature of
Role Plan administrator
Date 2021-11-14
Name of individual signing GARY KLEIN
Valid signature Filed with authorized/valid electronic signature
AFFILIATED DENTAL SPECIALISTS, LTD. PROFIT SHARING PLAN & TRUST 2020 363096708 2021-03-31 AFFILIATED DENTAL SPECIALISTS, LTD. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-08-01
Business code 621210
Sponsor’s telephone number 8473676068
Plan sponsor’s address ONE EAST PHILLIP RD., SUITE 102, VERNON HILLS, IL, 60061

Signature of
Role Plan administrator
Date 2021-03-31
Name of individual signing GARY KLEIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-03-31
Name of individual signing GARY KLEIN
Valid signature Filed with authorized/valid electronic signature
AFFILIATED DENTAL SPECIALISTS, LTD. PROFIT SHARING PLAN & TRUST 2019 363096708 2020-04-01 AFFILIATED DENTAL SPECIALISTS, LTD. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-08-01
Business code 621210
Sponsor’s telephone number 8473676068
Plan sponsor’s address ONE EAST PHILLIP RD., SUITE 102, VERNON HILLS, IL, 60061

Signature of
Role Plan administrator
Date 2020-04-01
Name of individual signing GARY KLEIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-04-01
Name of individual signing GARY KLEIN
Valid signature Filed with authorized/valid electronic signature
AFFILIATED DENTAL SPECIALISTS, LTD. PROFIT SHARING PLAN & TRUST 2018 363096708 2019-04-22 AFFILIATED DENTAL SPECIALISTS, LTD. 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-08-01
Business code 621210
Sponsor’s telephone number 8473676068
Plan sponsor’s address ONE EAST PHILLIP RD., SUITE 102, VERNON HILLS, IL, 60061

Signature of
Role Plan administrator
Date 2019-04-20
Name of individual signing GARY T. KLEIN, DDS
Valid signature Filed with authorized/valid electronic signature
AFFILIATED DENTAL SPECIALISTS, LTD. PROFIT SHARING PLAN & TRUST 2017 363096708 2018-03-15 AFFILIATED DENTAL SPECIALISTS, LTD. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-08-01
Business code 621210
Sponsor’s telephone number 8473676068
Plan sponsor’s address ONE EAST PHILLIP ROAD, SUITE102, VERNON HILLS, IL, 60061

Signature of
Role Plan administrator
Date 2018-03-14
Name of individual signing GARY T. KLEIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-03-14
Name of individual signing GARY T. KLEIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
AFFILIATED DENTAL SPECIALISTS, LTD. PROFIT SHARING PLAN & TRUST 2016 363096708 2017-02-13 AFFILIATED DENTAL SPECIALISTS, LTD. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-08-01
Business code 621210
Sponsor’s telephone number 8473676068
Plan sponsor’s address ONE EAST PHILLIP ROAD, SUITE102, VERNON HILLS, IL, 60061

Signature of
Role Plan administrator
Date 2017-02-12
Name of individual signing GARY T. KLEIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-02-12
Name of individual signing GARY T. KLEIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
AFFILIATED DENTAL SPECIALISTS, LTD. PROFIT SHARING PLAN & TRUST 2015 363096708 2016-03-07 AFFILIATED DENTAL SPECIALISTS, LTD. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-08-01
Business code 621210
Sponsor’s telephone number 8473676068
Plan sponsor’s address ONE EAST PHILLIP ROAD, SUITE102, VERNON HILLS, IL, 60061

Signature of
Role Plan administrator
Date 2016-03-03
Name of individual signing GARY T. KLEIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-03-03
Name of individual signing GARY T. KLEIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
AFFILIATED DENTAL SPECIALISTS, LTD. PROFIT SHARING PLAN & TRUST 2014 363096708 2015-03-04 AFFILIATED DENTAL SPECIALISTS, LTD. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-08-01
Business code 621210
Sponsor’s telephone number 8473676068
Plan sponsor’s address ONE EAST PHILLIP ROAD, SUITE102, VERNON HILLS, IL, 60061

Signature of
Role Plan administrator
Date 2015-03-04
Name of individual signing GARY T. KLEIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-03-04
Name of individual signing GARY T. KLEIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
AFFILIATED DENTAL SPECIALISTS, LTD. PROFIT SHARING PLAN & TRUST 2013 363096708 2014-02-21 AFFILIATED DENTAL SPECIALISTS, LTD. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-08-01
Business code 621210
Sponsor’s telephone number 8473676068
Plan sponsor’s address ONE EAST PHILLIP ROAD, SUITE102, VERNON HILLS, IL, 60061

Signature of
Role Plan administrator
Date 2014-02-20
Name of individual signing GARY T. KLEIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-02-20
Name of individual signing GARY T. KLEIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
AFFILIATED DENTAL SPECIALISTS, LTD. PROFIT SHARING PLAN & TRUST 2012 363096708 2013-02-25 AFFILIATED DENTAL SPECIALISTS, LTD. 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-08-01
Business code 621210
Sponsor’s telephone number 8473676068
Plan sponsor’s address ONE EAST PHILLIP ROAD, SUITE102, VERNON HILLS, IL, 60061

Signature of
Role Plan administrator
Date 2013-02-24
Name of individual signing GARY T. KLEIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-02-24
Name of individual signing GARY T. KLEIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
MICHAEL A HABER, 134 NORTH LA SALLE ST STE 2100, CHICAGO, 60602, COOK-NOT IN CITY OF CHICAGO Agent 2007-01-11

President

Name and Address Role
DAVID MADDOX, ONE E PHILLIP RD/#102, VERNON HILLS IL 60061 President

Historical Names

Name Change Date
AFFILIATED DENTAL SPECIALISTS, LTD. 2021-06-01

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 10000 2000000 1

Related by officers

MICHAEL A HABER, 134 NORTH LA SALLE ST STE 2100, CHICAGO, 60602, COOK-NOT IN CITY OF CHICAGO

DEARBORN TOOL & MANUFACTURING, INC. B. E. ATLAS COMPANY ADAMS MACHINERY COMPANY GOLF, INC.

Related by address

No related companies by address

Date of last update: 13 Mar 2025

Sources: Illinois Office of the Secretary of State

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