| Entity Name: | ANDREW WHITE DENTISTRY, P.C. |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Domestic BCA |
| Status: | Goodstanding |
| Date Formed: | 26 Jan 2015 |
| Company Number: | CORP_69865089 |
| File Number: | 69865089 |
| Type of Business: | Incorporated under the Professional Service Corporation Act |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANDREW WHITE DENTISTRY 401(K) PLAN | 2023 | 472909373 | 2024-10-01 | ANDREW WHITE DENTISTRY | 11 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-10-01 |
| Name of individual signing | ANDREW WHITE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 2173595050 |
| Plan sponsor’s address | 1112 BROADMOOR DRIVE, CHAMPAIGN, IL, 61821 |
Signature of
| Role | Plan administrator |
| Date | 2023-09-22 |
| Name of individual signing | ANDREW WHITE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 2173595050 |
| Plan sponsor’s address | 1112 BROADMOOR DRIVE, CHAMPAIGN, IL, 61821 |
Signature of
| Role | Plan administrator |
| Date | 2022-09-21 |
| Name of individual signing | ANDREW WHITE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 2173595050 |
| Plan sponsor’s address | 1112 BROADMOOR DRIVE, CHAMPAIGN, IL, 61821 |
Signature of
| Role | Plan administrator |
| Date | 2021-10-04 |
| Name of individual signing | ANDREW WHITE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| RANDALL H. GREEN, 306 W CHURCH ST, CHAMPAIGN, 61820, CHAMPAIGN | Agent | 2019-01-14 |
| Name and Address | Role |
|---|---|
| ANDREW S WHITE 1112 BROADMOORDR CHAMPAIGN IL 61821 | President |
| Name and Address | Role |
|---|---|
| ANDREW S WHITE 1112 BROADMOORDR CHAMPAIGN IL 61821 | Secretary |
| License Type | License Number | Status | License Code | License Description | Business Activity | Date Issued | Effective Date | Expiration Date |
|---|---|---|---|---|---|---|---|---|
| PROF SERVICE CORP | 060012403 | No data | No data | REGISTERED PROFESSIONAL SERVICE CORPORATION | No data | 2019-03-01 | 2021-10-29 | 2025-01-01 |
| Name | Change Date |
|---|---|
| ANDREW S, WHITE, DMD, P.C. | 2019-01-28 |
| Class | Series | Voting Rights | Authorized Shares | Issued Shares | Par Value |
|---|---|---|---|---|---|
| COMMON | No data | Voting Rights | 1000 | 1000000 | No data |
Date of last update: 16 Jan 2025
