| Entity Name: | NEZAR A. KASSEM DDS, P.C. |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Domestic BCA |
| Status: | Dissolved |
| Date Formed: | 07 Aug 2002 |
| Date of Dissolution: | 10 Jan 2020 |
| Company Number: | CORP_62382139 |
| File Number: | 62382139 |
| Type of Business: | Incorporated under the Medical Corporation Act |
| Date Status Change: | 10 Jan 2020 |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MAHOMET FAMILY DENTISTRY 401(K) PLAN | 2018 | 320030782 | 2019-06-27 | MAHOMET FAMILY DENTISTRY | 7 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2019-06-27 |
| Name of individual signing | NEZAR KASSEM |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 2175867878 |
| Plan sponsor’s address | 2012 TIN CUP ROAD, PO BOX 27, MAHOMET, IL, 61853 |
Signature of
| Role | Plan administrator |
| Date | 2019-11-02 |
| Name of individual signing | NEZAR KASSEM |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| EVAN D COOBS, 306 W CHURCH ST, CHAMPAIGN, 61820, CHAMPAIGN | Agent | 2018-09-05 |
| Name and Address | Role |
|---|---|
| NEZAR A KASSEM, 1314 E RIDGEFIELD DR MAHOMET IL 61853 | President |
| Name | Type | Effective Date | Cancellation Date | Cancellation Type | Last Renewal Date |
|---|---|---|---|---|---|
| MAHOMET FAMILY DENTISTRY | No data | 2017-11-10 | 2020-01-02 | Involuntary Cancellation | No data |
| Class | Series | Voting Rights | Authorized Shares | Issued Shares | Par Value |
|---|---|---|---|---|---|
| COMMON | No data | Voting Rights | 10000 | 100000 | No data |
Date of last update: 16 Jan 2025
