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  5. ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C.

ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C.

Company Details

Entity Name: ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 11 Feb 2003
Company Number: CORP_62633026
File Number: 62633026
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 & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. DEFINED BENEFIT PENSION PLAN 2022 421577809 2023-08-29 ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 8476232830
Plan sponsor’s address 202 S GREENLEAF ST STE A, GURNEE, IL, 600313399

Signature of
Role Plan administrator
Date 2023-08-29
Name of individual signing FABIAN LATOCHA
Valid signature Filed with authorized/valid electronic signature
ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. DEFINED BENEFIT PENSION PLAN 2022 421577809 2023-08-29 ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 8476232830
Plan sponsor’s address 202 S GREENLEAF ST STE A, GURNEE, IL, 600313399

Signature of
Role Plan administrator
Date 2023-08-29
Name of individual signing FABIAN LATOCHA
Valid signature Filed with authorized/valid electronic signature
ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. DEFINED BENEFIT PENSION PLAN 2021 421577809 2022-07-13 ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 8476232830
Plan sponsor’s address 202 S GREENLEAF ST STE A, GURNEE, IL, 600313399

Signature of
Role Plan administrator
Date 2022-07-13
Name of individual signing FABIAN LATOCHA
Valid signature Filed with authorized/valid electronic signature
ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. DEFINED BENEFIT PENSION PLAN 2020 421577809 2021-09-29 ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 8476232830
Plan sponsor’s address 202 S GREENLEAF ST STE A, GURNEE, IL, 600313399

Signature of
Role Plan administrator
Date 2021-09-29
Name of individual signing FABIAN LATOCHA
Valid signature Filed with authorized/valid electronic signature
ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. DEFINED BENEFIT PENSION PLAN 2019 421577809 2020-10-06 ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 8476232830
Plan sponsor’s address 202 S GREENLEAF ST STE A, GURNEE, IL, 600313399

Signature of
Role Plan administrator
Date 2020-10-06
Name of individual signing FABIAN LATOCHA
Valid signature Filed with authorized/valid electronic signature
ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. DEFINED BENEFIT PENSION PLAN 2018 421577809 2019-10-01 ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 8476232830
Plan sponsor’s address 202 S GREENLEAF ST STE A, GURNEE, IL, 600313399

Signature of
Role Plan administrator
Date 2019-10-01
Name of individual signing FABIAN LATOCHA
Valid signature Filed with authorized/valid electronic signature
ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. DEFINED BENEFIT PENSION PLAN 2017 421577809 2018-10-04 ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 8476232830
Plan sponsor’s address 202 S GREENLEAF ST STE A, GURNEE, IL, 600313399

Signature of
Role Plan administrator
Date 2018-10-04
Name of individual signing FABIAN LATOCHA
Valid signature Filed with authorized/valid electronic signature
ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. DEFINED BENEFIT PENSION PLAN 2016 421577809 2017-10-11 ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 8476232830
Plan sponsor’s address 202 S GREENLEAF ST STE A, GURNEE, IL, 600313399

Signature of
Role Plan administrator
Date 2017-10-11
Name of individual signing FABIAN LATOCHA
Valid signature Filed with authorized/valid electronic signature
ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. DEFINED BENEFIT PENSION PLAN 2015 421577809 2016-10-10 ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 8476232830
Plan sponsor’s address 202 S GREENLEAF ST STE A, GURNEE, IL, 600313399

Signature of
Role Plan administrator
Date 2016-10-10
Name of individual signing FABIAN LATOCHA
Valid signature Filed with authorized/valid electronic signature
ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. DEFINED BENEFIT PENSION PLAN 2014 421577809 2015-07-30 ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 8476232830
Plan sponsor’s address 202 S GREENLEAF ST STE A, GURNEE, IL, 600313399

Signature of
Role Plan administrator
Date 2015-07-30
Name of individual signing FABIAN LATOCHA
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
FABIAN D LATOCHA, 202 S GREENLEAF STE A, GURNEE, 60031, LAKE Agent 2008-02-06

President

Name and Address Role
FABIAN D LATOCHA, 202 S GREENLEAF ATE A, GURNEE 60031 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 10000 100000 No data

Related by officers

No related officers

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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