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  5. OPTOMETRIC EYECARE, INC.

OPTOMETRIC EYECARE, INC.

Company Details

Entity Name: OPTOMETRIC EYECARE, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 16 Jan 2007
Company Number: CORP_65302942
File Number: 65302942
Type of Business: All Inclusive Purpose
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
OPTOMETRIC EYECARE INC EMPLOYEE GROUP HEALTH PLAN 2021 432115099 2022-07-28 OPTOMETRIC EYECARE, INC. 4
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2021-01-01
Business code 621320
Sponsor’s telephone number 6183952676
Plan sponsor’s address 303 E MAIN ST, OLNEY, IL, 624502117

Signature of
Role Plan administrator
Date 2022-07-28
Name of individual signing CLARK DESHON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-07-28
Name of individual signing CLARK DESHON
Valid signature Filed with authorized/valid electronic signature
OPTOMETRIC EYECARE INC EMPLOYEE GROUP HEALTH PLAN 2020 432115099 2021-07-29 OPTOMETRIC EYECARE, INC. 3
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2020-01-01
Business code 621320
Sponsor’s telephone number 6183952676
Plan sponsor’s address 303 E MAIN ST, OLNEY, IL, 624502117

Signature of
Role Plan administrator
Date 2021-07-29
Name of individual signing CLARK DESHON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-07-29
Name of individual signing CLARK DESHON
Valid signature Filed with authorized/valid electronic signature
OPTOMETRIC EYECARE INC EMPLOYEE GROUP HEALTH PLAN 2019 432115099 2020-07-09 OPTOMETRIC EYECARE, INC. 6
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2019-01-01
Business code 621320
Sponsor’s telephone number 6183952676
Plan sponsor’s address 303 E MAIN ST, OLNEY, IL, 624502117

Signature of
Role Plan administrator
Date 2020-07-09
Name of individual signing CLARK DESHON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-09
Name of individual signing CLARK DESHON
Valid signature Filed with authorized/valid electronic signature
OPTOMETRIC EYECARE INC EMPLOYEE GROUP HEALTH PLAN 2018 432115099 2019-07-12 OPTOMETRIC EYECARE, INC. 5
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2018-01-01
Business code 621320
Sponsor’s telephone number 6183952676
Plan sponsor’s address 303 E MAIN ST, OLNEY, IL, 624502117

Signature of
Role Plan administrator
Date 2019-07-12
Name of individual signing CLARK DESHON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-07-12
Name of individual signing CLARK DESHON
Valid signature Filed with authorized/valid electronic signature
OPTOMETRIC EYECARE INC EMPLOYEE GROUP HEALTH PLAN 2017 432115099 2018-07-24 OPTOMETRIC EYECARE, INC. 6
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2017-01-01
Business code 621320
Sponsor’s telephone number 6183952676
Plan sponsor’s address 303 E MAIN ST, OLNEY, IL, 624502117

Signature of
Role Plan administrator
Date 2018-07-24
Name of individual signing CLARK DESHON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-07-24
Name of individual signing CLARK DESHON
Valid signature Filed with authorized/valid electronic signature
OPTOMETRIC EYECARE INC EMPLOYEE GROUP HEALTH PLAN 2016 432115099 2017-07-31 OPTOMETRIC EYECARE, INC. 6
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2016-01-01
Business code 621320
Sponsor’s telephone number 6183952676
Plan sponsor’s address 429 S WHITTLE AVE, OLNEY, IL, 624502262

Signature of
Role Plan administrator
Date 2017-07-31
Name of individual signing CLARK DESHON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-31
Name of individual signing CLARK DESHON
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
CLARK EDWARD DESHON, 1216 CYPRESS DR, OLNEY, 62450, RICHLAND Agent 2018-03-22

President

Name and Address Role
CLARK EDWARD DESHON, 1216 CYPRESS RD OLNEY IL 62450 President

Secretary

Name and Address Role
CAMILYNN DESHON Secretary

Shares

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

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
8185288409 2021-02-13 0507 PPS 303 E Main St, Olney, IL, 62450-2117
Loan Status Date 2022-02-18
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 76052
Loan Approval Amount (current) 76052
Undisbursed Amount 0
Franchise Name Vision Source
Lender Location ID 188567
Servicing Lender Name Loan Source Incorporated
Servicing Lender Address 353 East 83rd Street Suite 3H, NEW YORK, NY, 10028
Rural or Urban Indicator R
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Olney, RICHLAND, IL, 62450-2117
Project Congressional District IL-12
Number of Employees 8
NAICS code 621320
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 29599
Originating Lender Name Northeast Bank
Originating Lender Address LEWISTON, ME
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 76614.58
Forgiveness Paid Date 2021-11-16
5740527006 2020-04-06 0507 PPP 303 E MAIN ST, OLNEY, IL, 62450-2117
Loan Status Date 2022-02-18
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 80830
Loan Approval Amount (current) 80803
Undisbursed Amount 0
Franchise Name -
Lender Location ID 188567
Servicing Lender Name Loan Source Incorporated
Servicing Lender Address 353 East 83rd Street Suite 3H, NEW YORK, NY, 10028
Rural or Urban Indicator R
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address OLNEY, RICHLAND, IL, 62450-2117
Project Congressional District IL-12
Number of Employees 9
NAICS code 621320
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 36581
Originating Lender Name Stearns Bank National Association
Originating Lender Address SAINT CLOUD, MN
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 81597.75
Forgiveness Paid Date 2021-04-15

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Date of last update: 13 Mar 2025

Sources: Illinois Office of the Secretary of State

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