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  5. BLEW FAMILY DENTISTRY, P.C.

BLEW FAMILY DENTISTRY, P.C.

Company Details

Entity Name: BLEW FAMILY DENTISTRY, P.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 30 Dec 2002
Company Number: CORP_62571764
File Number: 62571764
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
BLEW FAMILY DENTISTRY 401(K) SAVINGS PLAN 2015 363147931 2017-08-14 BLEW FAMILY DENTISTRY 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1981-12-01
Business code 621210
Sponsor’s telephone number 3097974336
Plan sponsor’s address 604 35TH AVE, MOLINE, IL, 612656174

Signature of
Role Plan administrator
Date 2017-08-14
Name of individual signing BRYAN BLEW
Valid signature Filed with authorized/valid electronic signature
BLEW FAMILY DENTISTRY 401(K) SAVINGS PLAN 2014 363147931 2015-07-13 BLEW FAMILY DENTISTRY 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1981-12-01
Business code 621210
Sponsor’s telephone number 3097974336
Plan sponsor’s address 604 35TH AVENUE, MOLINE, IL, 61265

Signature of
Role Plan administrator
Date 2015-07-13
Name of individual signing BRYAN BLEW
Valid signature Filed with authorized/valid electronic signature
BLEW FAMILY DENTISTRY 401(K) SAVINGS PLAN 2013 363147931 2014-02-27 BLEW FAMILY DENTISTRY 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1981-12-01
Business code 621210
Sponsor’s telephone number 3097974336
Plan sponsor’s address 604 35TH AVENUE, MOLINE, IL, 61265

Signature of
Role Plan administrator
Date 2014-02-27
Name of individual signing BRYAN BLEW
Valid signature Filed with authorized/valid electronic signature
BLEW FAMILY DENTISTRY 401K SAVINGS PLAN 2012 363147931 2013-03-04 BLEW FAMILY DENTISTRY 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1981-12-01
Business code 621210
Sponsor’s telephone number 3097974336
Plan sponsor’s address 604 35TH AVENUE, MOLINE, IL, 61265

Plan administrator’s name and address
Administrator’s EIN 363147931
Plan administrator’s name BLEW FAMILY DENTISTRY
Plan administrator’s address 604 35TH AVENUE, MOLINE, IL, 61265
Administrator’s telephone number 3097974336

Signature of
Role Plan administrator
Date 2013-03-04
Name of individual signing BRYAN BLEW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-03-04
Name of individual signing BRYAN BLEW
Valid signature Filed with authorized/valid electronic signature
BLEW FAMILY DENTISTRY 401K SAVINGS PLAN 2011 363147931 2012-02-21 BLEW FAMILY DENTISTRY 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1981-12-01
Business code 621210
Sponsor’s telephone number 3097974336
Plan sponsor’s address 604 35TH AVENUE, MOLINE, IL, 61265

Plan administrator’s name and address
Administrator’s EIN 363147931
Plan administrator’s name BLEW FAMILY DENTISTRY
Plan administrator’s address 604 35TH AVENUE, MOLINE, IL, 61265
Administrator’s telephone number 3097974336

Signature of
Role Plan administrator
Date 2012-02-21
Name of individual signing BRYAN BLEW
Valid signature Filed with authorized/valid electronic signature
BLEW FAMILY DENTISTRY 401K SAVINGS PLAN 2010 363147931 2011-03-01 BLEW FAMILY DENTISTRY 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1981-12-01
Business code 621210
Sponsor’s telephone number 3097974336
Plan sponsor’s address 604 35TH AVENUE, MOLINE, IL, 61265

Plan administrator’s name and address
Administrator’s EIN 363147931
Plan administrator’s name BLEW FAMILY DENTISTRY
Plan administrator’s address 604 35TH AVENUE, MOLINE, IL, 61265
Administrator’s telephone number 3097974336

Signature of
Role Plan administrator
Date 2011-03-01
Name of individual signing BRYAN BLEW
Valid signature Filed with authorized/valid electronic signature
BLEW FAMILY DENTISTRY 401K SAVINGS PLAN 2009 363147931 2010-06-22 BLEW FAMILY DENTISTRY 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1981-12-01
Business code 621210
Sponsor’s telephone number 3097974336
Plan sponsor’s address 604 35TH AVENUE, MOLINE, IL, 61265

Plan administrator’s name and address
Administrator’s EIN 363147931
Plan administrator’s name BLEW FAMILY DENTISTRY
Plan administrator’s address 604 35TH AVENUE, MOLINE, IL, 61265
Administrator’s telephone number 3097974336

Signature of
Role Plan administrator
Date 2010-06-21
Name of individual signing BRYAN BLEW
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
BRYAN C BLEW, 609 22ND ST, MOLINE, 61265, ROCK ISLAND Agent 2016-11-22

President

Name and Address Role
BRYAN C BLEW DDS, 609 22ND ST, MOLINE, IL, 61265 President

Secretary

Name and Address Role
BRYAN BLEW 3901 25TH AVE CT ROCK ISLAND IL 61201 Secretary

Historical Names

Name Change Date
BRYAN C. BLEW, D.D.S., P.C. 2011-01-13

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
SINGLE No data Voting Rights 10000 1000000 1

Related by officers

No related officers

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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