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  5. SOUTHERN ILLINOIS SMILES, P.C.

SOUTHERN ILLINOIS SMILES, P.C.

Company Details

Entity Name: SOUTHERN ILLINOIS SMILES, P.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 29 May 2007
Company Number: CORP_65565951
File Number: 65565951
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
SOUTHERN ILLINOIS SMILES RETIREMENT PLAN 2023 260402041 2024-06-27 SOUTHERN ILLINOIS SMILES P. C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 6186625116
Plan sponsor’s address 217 E 2ND ST, FLORA, IL, 62839

Signature of
Role Plan administrator
Date 2024-06-27
Name of individual signing SCOTT SUNTRUP
Valid signature Filed with authorized/valid electronic signature
SOUTHERN ILLINOIS SMILES RETIREMENT PLAN 2022 260402041 2023-06-07 SOUTHERN ILLINOIS SMILES P. C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 6186625116
Plan sponsor’s address 217 E 2ND ST, FLORA, IL, 62839

Signature of
Role Plan administrator
Date 2023-06-07
Name of individual signing SCOTT SUNTRUP
Valid signature Filed with authorized/valid electronic signature
SOUTHERN ILLINOIS SMILES RETIREMENT PLAN 2021 260402041 2022-08-19 SOUTHERN ILLINOIS SMILES P. C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 6186625116
Plan sponsor’s address 217 E 2ND ST, FLORA, IL, 62839

Signature of
Role Plan administrator
Date 2022-08-19
Name of individual signing SCOTT SUNTRUP
Valid signature Filed with authorized/valid electronic signature
SOUTHERN ILLINOIS SMILES RETIREMENT PLAN 2020 260402041 2021-06-11 SOUTHERN ILLINOIS SMILES P. C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 6186625116
Plan sponsor’s address 1004 HONEY LOCUST LANE, XENIA, IL, 62899

Signature of
Role Plan administrator
Date 2021-06-11
Name of individual signing SCOTT SUNTRUP
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-06-11
Name of individual signing SCOTT SUNTRUP
Valid signature Filed with authorized/valid electronic signature
SOUTHERN ILLINOIS SMILES RETIREMENT PLAN 2019 260402041 2020-02-04 SOUTHERN ILLINOIS SMILES P. C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 6186625116
Plan sponsor’s address 1004 HONEY LOCUST LANE, XENIA, IL, 62889

Signature of
Role Plan administrator
Date 2020-02-04
Name of individual signing SCOTT SUNTRUP
Valid signature Filed with authorized/valid electronic signature
SOUTHERN ILLINOIS SMILES RETIREMENT PLAN 2018 260402041 2019-07-01 SOUTHERN ILLINOIS SMILES P. C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 6186625116
Plan sponsor’s address 1004 HONEY LOCUST LANE, XENIA, IL, 62889

Signature of
Role Plan administrator
Date 2019-07-01
Name of individual signing SCOTT SUNTRUP
Valid signature Filed with authorized/valid electronic signature
SOUTHERN ILLINOIS SMILES RETIREMENT PLAN 2017 260402041 2018-04-24 SOUTHERN ILLINOIS SMILES P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 6186625116
Plan sponsor’s address 1004 HONEY LOCUST LANE, XENIA, IL, 62889

Signature of
Role Plan administrator
Date 2018-04-24
Name of individual signing SCOTT SUNTRUP
Valid signature Filed with authorized/valid electronic signature
SOUTHERN ILLINOIS SMILES RETIREMENT PLAN 2016 260402041 2017-01-31 SOUTHERN ILLINOIS SMILES P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 6186625116
Plan sponsor’s address 1004 HONEY LOCUST LANE, XENIA, IL, 62889

Signature of
Role Plan administrator
Date 2017-01-31
Name of individual signing SCOTT SUNTRUP
Valid signature Filed with authorized/valid electronic signature
SOUTHERN ILLINOIS SMILES RETIREMENT PLAN 2015 260402041 2016-01-29 SOUTHERN ILLINOIS SMILES P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 6186625116
Plan sponsor’s address 1004 HONEY LOCUST LANE, XENIA, IL, 62889

Signature of
Role Plan administrator
Date 2016-01-29
Name of individual signing SCOTT SUNTRUP
Valid signature Filed with authorized/valid electronic signature
SOUTHERN ILLINOIS SMILES RETIREMENT PLAN 2014 260402041 2015-01-19 SOUTHERN ILLINOIS SMILES P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621210
Sponsor’s telephone number 6186625116
Plan sponsor’s address 1004 HONEY LOCUST LANE, XENIA, IL, 62889

Signature of
Role Plan administrator
Date 2015-01-19
Name of individual signing SCOTT SUNTRUP
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
SCOTT C SUNTRUP, 1004 HONEY LOCUST LANE, XENIA, 62899, CLAY Agent 2009-05-04

President

Name and Address Role
SCOTT C SUNTRUP 1004 HONEY LOCUST LN XENIA IL 62899 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 10000 1000000 No data

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State

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