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  5. ROXANNE P BENISON DMD MS, P.C.

ROXANNE P BENISON DMD MS, P.C.

Company Details

Entity Name: ROXANNE P BENISON DMD MS, P.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 14 Aug 2007
Company Number: CORP_65693593
File Number: 65693593
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
SIGNATURE ENDODONTICS, P. C. PROFIT SHARING PLAN 2023 320214841 2024-01-07 ROXANNE P BENISON, DMD MS, INC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 6184076329
Plan sponsor’s address 1063 S STATE ROUTE 157 STE 2-108, EDWARDSVILLE, IL, 620253695

Signature of
Role Plan administrator
Date 2024-01-07
Name of individual signing ROXANNE BENISON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-01-07
Name of individual signing ROXANNE BENISON
Valid signature Filed with authorized/valid electronic signature
SIGNATURE ENDODONTICS, P.C. PROFIT SHARING PLAN 2013 320214841 2014-03-10 SIGNATURE ENDODONTICS, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 6186592030
Plan sponsor’s mailing address 22 B GLEN ED PROFESSIONAL PARK, GLEN CARBON, IL, 62034
Plan sponsor’s address 22 B GLEN ED PROFESSIONAL PARK, GLEN CARBONE, IL, 62034

Number of participants as of the end of the plan year
Active participants 5
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 5
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 3
SIGNATURE ENDODONTICS, P.C. PROFIT SHARING PLAN 2012 320214841 2013-03-27 SIGNATURE ENDODONTICS, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 6186592030
Plan sponsor’s mailing address 22 B GLEN ED PROFESSIONAL PARK, GLEN CARBON, IL, 62034
Plan sponsor’s address 22 B GLEN ED PROFESSIONAL PARK, GLEN CARBONE, IL, 62034

Number of participants as of the end of the plan year
Active participants 8
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 8
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 1

Signature of
Role Plan administrator
Date 2013-03-27
Name of individual signing ROXANNE BENISON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-03-27
Name of individual signing ROXANNE BENISON
Valid signature Filed with authorized/valid electronic signature
SIGNATURE ENDODONTICS, P.C. PROFIT SHARING PLAN 2011 320214841 2012-05-07 SIGNATURE ENDODONTICS, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 6186592030
Plan sponsor’s mailing address 22 B GLEN ED PROFESSIONAL PARK, GLEN CARBON, IL, 62034
Plan sponsor’s address 22 B GLEN ED PROFESSIONAL PARK, GLEN CARBONE, IL, 62034

Plan administrator’s name and address
Administrator’s EIN 320214841
Plan administrator’s name SIGNATURE ENDODONTICS, P.C.
Plan administrator’s address 22 B GLEN ED PROFESSIONAL PARK, GLEN CARBON, IL, 62034
Administrator’s telephone number 6186592030

Number of participants as of the end of the plan year
Active participants 6
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 6
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2012-05-07
Name of individual signing ROXANNE BENISON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-05-07
Name of individual signing ROXANNE BENISON
Valid signature Filed with authorized/valid electronic signature
SIGNATURE ENDODONTICS, P.C. PROFIT SHARING PLAN 2010 320214841 2011-04-25 SIGNATURE ENDODONTICS, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 6186592030
Plan sponsor’s mailing address 40 A EDWARDSVILLE PROFESSIONAL PARK, EDWARDSVILLE, IL, 62025
Plan sponsor’s address 40 A EDWARDSVILLE PROFESSIONAL PARK, EDWARDSVILLE, IL, 62025

Plan administrator’s name and address
Administrator’s EIN 320214841
Plan administrator’s name SIGNATURE ENDODONTICS, P.C.
Plan administrator’s address 40 A EDWARDSVILLE PROFESSIONAL PARK, EDWARDSVILLE, IL, 62025
Administrator’s telephone number 6186592030

Number of participants as of the end of the plan year
Active participants 6
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 6
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2011-04-25
Name of individual signing ROXANNE BENISON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-04-25
Name of individual signing ROXANNE BENISON
Valid signature Filed with authorized/valid electronic signature
SIGNATURE ENDODONTICS, P.C. PROFIT SHARING PLAN 2009 320214841 2010-09-29 SIGNATURE ENDODONTICS, P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 6186592030
Plan sponsor’s address 40 A EDWARDSVILLE PROFESSIONAL PARK, EDWARDSVILLE, IL, 62025

Plan administrator’s name and address
Administrator’s EIN 320214841
Plan administrator’s name SIGNATURE ENDODONTICS, P.C.
Plan administrator’s address 40 A EDWARDSVILLE PROFESSIONAL PARK, EDWARDSVILLE, IL, 62025
Administrator’s telephone number 6186592030

Signature of
Role Plan administrator
Date 2010-09-29
Name of individual signing ROXANNE P. BENISON, DMD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-09-29
Name of individual signing ROXANNE P. BENISON, DMD
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
ROXANNE P BENISON, 22 GLEN ED PROFESSIONAL PK #B, GLEN CARBON, 62034, MADISON Agent 2014-04-03

President

Name and Address Role
ROXANNE BENISON 22 GLEN ED PROF PK, GLEN CARBON, IL 62034 President

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
ROXANNE P. BENISON DMD, MS No data 2008-05-23 2011-01-03 Involuntary Cancellation No data

Historical Names

Name Change Date
ROXANNE P BENISON DMD MS, INC. 2024-05-20
SIGNATURE ENDODONTICS, P.C. 2022-09-21

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 100 100000 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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