| Entity Name: | FULL SMILE FAMILY DENTIST DISSOLUTION, P.C. |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Domestic BCA |
| Status: | Goodstanding |
| Date Formed: | 09 Sep 2004 |
| Company Number: | CORP_63740837 |
| File Number: | 63740837 |
| Type of Business: | Incorporated under the Professional Service Corporation Act |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FULL SMILE FAMILY DENTIST, P.C. 401 (K) PLAN | 2022 | 201771535 | 2023-07-12 | FULL SMILE FAMILY DENTIST, P.C. | 31 | |||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2023-07-12 |
| Name of individual signing | EDISON ISHAYA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 7732350000 |
| Plan sponsor’s address | 3939 W. FULLERTON AVE., CHICAGO, IL, 60647 |
Signature of
| Role | Plan administrator |
| Date | 2022-06-29 |
| Name of individual signing | EDISON ISHAYA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 7732350000 |
| Plan sponsor’s address | 3939 W. FULLERTON AVE., CHICAGO, IL, 60647 |
Signature of
| Role | Plan administrator |
| Date | 2021-10-13 |
| Name of individual signing | EDISON ISHAYA |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| EDISON A ISHAYA, 3939 W FULLERTON AVE, CHICAGO, 60647, COOK-NOT IN CITY OF CHICAGO | Agent | 2015-07-17 |
| Name and Address | Role |
|---|---|
| EDISON A ISHAYA 12 HIBBARD RD WINNETKA IL 60093 | President |
| Name | Change Date |
|---|---|
| FULL SMILE FAMILY DENTIST, P.C. | 2023-12-07 |
| Class | Series | Voting Rights | Authorized Shares | Issued Shares | Par Value |
|---|---|---|---|---|---|
| COMMON | No data | Voting Rights | 10000 | 1000000 | No data |
Date of last update: 16 Jan 2025
