ANTHONY O. AMIEWALAN, M.D., S.C.

Company Details

Entity Name:	ANTHONY O. AMIEWALAN, M.D., S.C.
Jurisdiction:	Illinois
Entity Type:	Corporation - Domestic BCA
Status:	Dissolved
Date Formed:	16 Jul 2009
Date of Dissolution:	08 Dec 2023
Company Number:	CORP_66625796
File Number:	66625796
Type of Business:	Incorporated under the Medical Corporation Act
Date Status Change:	08 Dec 2023
Place of Formation:	ILLINOIS

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

ANTHONY O. AMIEWALAN, M.D., S.C. PROFIT SHARING PLAN

2010

341836517

2011-10-17

ANTHONY O. AMIEWALAN, M.D., S.C.

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1992-01-01
Business code	621111
Sponsor’s telephone number	2174220560
Plan sponsor’s mailing address	1770 EAST LAKE SHORE DRIVE, DECATUR, IL, 625213832
Plan sponsor’s address	1770 EAST LAKE SHORE DRIVE, DECATUR, IL, 625213832

Plan administrator’s name and address

Administrator’s EIN	341836517
Plan administrator’s name	ANTHONY O. AMIEWALAN, M.D., S.C.
Plan administrator’s address	1770 EAST LAKE SHORE DRIVE, DECATUR, IL, 625213832
Administrator’s telephone number	2174220560

Number of participants as of the end of the plan year

Active participants	4
Other retired or separated participants entitled to future benefits	3
Number of participants with account balances as of the end of the plan year	7

Signature of

Role	Plan administrator
Date	2011-10-17
Name of individual signing	BRENT GAMBILL
Valid signature	Filed with authorized/valid electronic signature

Name and Address	Role	Appointment Date
GEORGIA AMIEWALAN, 1750 E LAKE SHORE DR, DECATUR, 62521, MACON	Agent	2009-07-16

Name and Address	Role
ANTHONY AMIEWALAN, 1750 E LAKESHORE #320 DECATUR IL 62521	President

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

Date of last update: 27 Jan 2025