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PRIME SMILE DESIGN, LTD.

Company Details

Entity Name: PRIME SMILE DESIGN, LTD.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 13 Dec 2016
Company Number: CORP_70914182
File Number: 70914182
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
PRIME SMILE DESIGN, LTD. 401(K) PLAN 2023 814775995 2024-10-11 PRIME SMILE DESIGN, LTD. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-01-01
Business code 621210
Sponsor’s telephone number 9177673316
Plan sponsor’s address 1440 N. LAKE SHORE DRIVE, APT. 19A, CHICAGO, IL, 60610

Signature of

Role Plan administrator
Date 2024-10-11
Name of individual signing DARREN JOSSEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-10-11
Name of individual signing DARREN JOSSEL
Valid signature Filed with authorized/valid electronic signature
PRIME SMILE DESIGN, LTD. 401(K) PLAN 2022 814775995 2023-10-02 PRIME SMILE DESIGN, LTD. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-01-01
Business code 621210
Sponsor’s telephone number 9177673316
Plan sponsor’s address 1440 N. LAKE SHORE DRIVE, APT. 19A, CHICAGO, IL, 60610

Signature of

Role Plan administrator
Date 2023-10-02
Name of individual signing DARREN JOSSEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-02
Name of individual signing DARREN JOSSEL
Valid signature Filed with authorized/valid electronic signature
PRIME SMILE DESIGN, LTD. 401(K) PLAN 2021 814775995 2022-10-13 PRIME SMILE DESIGN, LTD. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-01-01
Business code 621210
Sponsor’s telephone number 9177673316
Plan sponsor’s address 1440 N. LAKE SHORE DRIVE, APT. 19A, CHICAGO, IL, 60610

Signature of

Role Plan administrator
Date 2022-10-13
Name of individual signing MICHAEL W. BLITSTEIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-10-13
Name of individual signing MICHAEL W. BLITSTEIN
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
ANDRE S AMARANTE, 2424 MAIN ST, EVANSTON, 60202, COOK-NOT IN CITY OF CHICAGO Agent 2019-03-22

President

Name and Address Role
ANDRE AMARANTE 1440 N LAKE SHORE APT 19A, CHICAGO, IL, 60610 President

Secretary

Name and Address Role
NONE Secretary

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
WAY DENTAL Assume Name 2020-12-03 2020-12-03 No data No data
PRIME SMILE DESIGN, LTD No data 2020-10-27 2020-12-03 Voluntary Cancellation No data

Shares

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

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
2705918307 2021-01-21 0507 PPS 1440 N Lake Shore Dr Apt 19A, Chicago, IL, 60610-1685
Loan Status Date 2021-09-24
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 32525
Loan Approval Amount (current) 32525
Undisbursed Amount 0
Franchise Name -
Lender Location ID 9551
Servicing Lender Name Bank of America, National Association
Servicing Lender Address 100 N Tryon St, Ste 170, CHARLOTTE, NC, 28202-4024
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Chicago, COOK, IL, 60610-1685
Project Congressional District IL-05
Number of Employees 5
NAICS code 621210
Borrower Race White
Borrower Ethnicity Hispanic or Latino
Business Type Corporation
Originating Lender ID 9551
Originating Lender Name Bank of America, National Association
Originating Lender Address CHARLOTTE, NC
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 32710.35
Forgiveness Paid Date 2021-08-18
1771917304 2020-04-28 0507 PPP 1440 N LAKE SHORE DR APT 19A, CHICAGO, IL, 60610-1685
Loan Status Date 2021-04-16
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 29557
Loan Approval Amount (current) 29557
Undisbursed Amount 0
Franchise Name -
Lender Location ID 9551
Servicing Lender Name Bank of America, National Association
Servicing Lender Address 100 N Tryon St, Ste 170, CHARLOTTE, NC, 28202-4024
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address CHICAGO, COOK, IL, 60610-1685
Project Congressional District IL-05
Number of Employees 3
NAICS code 541990
Borrower Race White
Borrower Ethnicity Hispanic or Latino
Business Type Corporation
Originating Lender ID 9551
Originating Lender Name Bank of America, National Association
Originating Lender Address CHARLOTTE, NC
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 29801.55
Forgiveness Paid Date 2021-02-25

Date of last update: 13 Feb 2025

Sources: Illinois Office of the Secretary of State