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GLEN ELLYN DENTISTRY P.C.

GLEN ELLYN DENTISTRY P.C.

Company Details

Entity Name:	GLEN ELLYN DENTISTRY P.C.
Jurisdiction:	Illinois
Entity Type:	Corporation - Domestic BCA
Status:	Goodstanding
Date Formed:	02 Nov 2006
Company Number:	CORP_65229749
File Number:	65229749
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

GLEN ELLYN DENTISTRY 401K PLAN

2011

205822536

2012-05-21

GLEN ELLYN DENTISTRY

3

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2011-01-01
Business code	621210
Sponsor’s telephone number	6309420727
Plan sponsor’s address	577 PENNSYLVANIA AVE., STE. 100, GLEN ELLYN, IL, 60137

Plan administrator’s name and address

Administrator’s EIN	205822536
Plan administrator’s name	GLEN ELLYN DENTISTRY
Plan administrator’s address	577 PENNSYLVANIA AVE., STE. 100, GLEN ELLYN, IL, 60137
Administrator’s telephone number	6309420727

Signature of

Role	Plan administrator
Date	2012-05-21
Name of individual signing	CHARISE M PETRELLI
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2012-05-21
Name of individual signing	CHARISE M PETRELLI
Valid signature	Filed with authorized/valid electronic signature

Agent

Name and Address	Role	Appointment Date
CHARISE MARIE PETRELLI, 462 PROSPECT AVE, GLEN ELLYN, 60137, DU PAGE	Agent	2018-10-02

President

Name and Address	Role
CHARISE PETRELLI 21W405 WALNUT RD GLEN ELLYN 60137	President

Secretary

Name and Address	Role
NONE	Secretary

Historical Names

Name	Change Date
CHARISE M. PETRELLI, DDS, P.C.	2010-05-24

Shares

Class	Series	Voting Rights	Authorized Shares	Issued Shares	Par Value
COMMON	No data	Voting Rights	100000	1000000	No data

Date of last update: 27 Jan 2025

Sources: Illinois Office of the Secretary of State