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  5. PARK DENTAL GROUP, INC.

PARK DENTAL GROUP, INC.

Company Details

Entity Name: PARK DENTAL GROUP, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 09 Jan 2004
Company Number: CORP_63309389
File Number: 63309389
Type of Business: All Inclusive Purpose
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PARK DENTAL GROUP INC 401K PROFIT SHARING PLAN 2012 200599990 2013-10-14 PARK DENTAL GROUP INC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 8152677878
Plan sponsor’s address 24047 W LOCKPORT STREET - SUITE 207, PLAINFIELD, IL, 60544

Signature of
Role Plan administrator
Date 2013-09-24
Name of individual signing JAE S ROH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-09-24
Name of individual signing JAE S ROH
Valid signature Filed with authorized/valid electronic signature
PARK DENTAL GROUP INC 401K PROFIT SHARING PLAN 2011 200599990 2012-07-27 PARK DENTAL GROUP INC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 8152677878
Plan sponsor’s address 530 LOCKPORT STREET - SUITE 210, PLAINFIELD, IL, 605443020

Plan administrator’s name and address
Administrator’s EIN 200599990
Plan administrator’s name PARK DENTAL GROUP INC
Plan administrator’s address 530 LOCKPORT STREET - SUITE 210, PLAINFIELD, IL, 605443020
Administrator’s telephone number 8152677878

Signature of
Role Plan administrator
Date 2012-07-23
Name of individual signing JAE S ROH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-23
Name of individual signing JAE S ROH
Valid signature Filed with authorized/valid electronic signature
PARK DENTAL GROUP INC 401K PROFIT SHARING PLAN 2010 200599990 2011-10-07 PARK DENTAL GROUP INC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 8152677878
Plan sponsor’s address 530 LOCKPORT STREET - SUITE 210, PLAINFIELD, IL, 605443020

Plan administrator’s name and address
Administrator’s EIN 200599990
Plan administrator’s name PARK DENTAL GROUP INC
Plan administrator’s address 530 LOCKPORT STREET - SUITE 210, PLAINFIELD, IL, 605443020
Administrator’s telephone number 8152677878

Signature of
Role Plan administrator
Date 2011-10-07
Name of individual signing JAE S ROH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-07
Name of individual signing JAE S ROH
Valid signature Filed with authorized/valid electronic signature
PARK DENTAL GROUP INC 401K PROFIT SHARING PLAN 2009 200599990 2010-10-12 PARK DENTAL GROUP INC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 8152677878
Plan sponsor’s address 530 LOCKPORT STREET - SUITE 210, PLAINFIELD, IL, 605443020

Plan administrator’s name and address
Administrator’s EIN 200599990
Plan administrator’s name PARK DENTAL GROUP INC
Plan administrator’s address 530 LOCKPORT STREET - SUITE 210, PLAINFIELD, IL, 605443020
Administrator’s telephone number 8152677878

Signature of
Role Plan administrator
Date 2010-10-12
Name of individual signing JAE ROH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-12
Name of individual signing JAE S. ROH
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
INAH PARK, 716 69TH ST, WILLOWBROOK, 60527, DU PAGE Agent 2005-01-03

Secretary

Name and Address Role
JAE ROH Secretary

President

Name and Address Role
INAH PARK, 716 69TH STREET, WILLOWBROOK, 60527 President

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
PARK FAMILY DENTAL Assume Name 2006-08-09 No data No data No data

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 1000 1000000 1

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 23 Jan 2025

Sources: Illinois Office of the Secretary of State

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