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  5. SASA OF ILLINOIS, LLC

SASA OF ILLINOIS, LLC

Company Details

Entity Name: SASA OF ILLINOIS, LLC
Jurisdiction: Illinois
Entity Type: Limited Liability Company
Status: Involuntary Dissolution
Date Formed: 25 Jan 2006
Company Number: LLC_01745239
File Number: 01745239
Type of Management: Member Managed
Date Status Change: 14 Jul 2017
Expiration Date: 20 Jan 2050
Address 461 HIGHWAY F, TWIN LAKES, 53181, WI
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PERIODONTICS, LLC 401(K) PROFIT SHARING PLAN 2012 263078778 2013-06-12 PERIODONTICS, LLC 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 3126412572
Plan sponsor’s address 25 EAST WASHINGTON, SUITE 1125, CHICAGO, IL, 60602

Signature of
Role Plan administrator
Date 2013-06-12
Name of individual signing STEPHEN RUSSO DMD
Valid signature Filed with authorized/valid electronic signature
PERIODONTICS, L.L.C. CASH BALANCE PLAN 2012 263078778 2013-06-12 PERIODONTICS, LLC 24
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 3126412572
Plan sponsor’s address 25 EAST WASHINGTON, SUITE 1125, CHICAGO, IL, 60602

Signature of
Role Plan administrator
Date 2013-06-12
Name of individual signing STEPHEN RUSSO DMD
Valid signature Filed with authorized/valid electronic signature
PERIODONTICS, L.L.C. CASH BALANCE PLAN 2011 263078778 2012-10-15 PERIODONTICS, LLC 22
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 3126412572
Plan sponsor’s address 25 EAST WASHINGTON, SUITE 1125, CHICAGO, IL, 60602

Plan administrator’s name and address
Administrator’s EIN 263078778
Plan administrator’s name PERIODONTICS, LLC
Plan administrator’s address 25 EAST WASHINGTON, SUITE 1125, CHICAGO, IL, 60602
Administrator’s telephone number 3126412572

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing STEPHEN RUSSO DMD
Valid signature Filed with authorized/valid electronic signature
PERIODONTICS, LLC 401(K) PROFIT SHARING PLAN 2011 263078778 2012-10-09 PERIODONTICS, LLC 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 3126412572
Plan sponsor’s address 25 EAST WASHINGTON, SUITE 1125, CHICAGO, IL, 60602

Plan administrator’s name and address
Administrator’s EIN 263078778
Plan administrator’s name PERIODONTICS, LLC
Plan administrator’s address 25 EAST WASHINGTON, SUITE 1125, CHICAGO, IL, 60602
Administrator’s telephone number 3126412572

Signature of
Role Plan administrator
Date 2012-10-09
Name of individual signing STEPHEN RUSSO DMD
Valid signature Filed with authorized/valid electronic signature
PERIODONTICS, LLC 401(K) PROFIT SHARING PLAN 2010 263078778 2011-03-29 PERIODONTICS, LLC 30
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 3126412572
Plan sponsor’s address 25 EAST WASHINGTON, SUITE 1125, CHICAGO, IL, 60602

Plan administrator’s name and address
Administrator’s EIN 263078778
Plan administrator’s name PERIODONTICS, LLC
Plan administrator’s address 25 EAST WASHINGTON, SUITE 1125, CHICAGO, IL, 60602
Administrator’s telephone number 3126412572

Signature of
Role Plan administrator
Date 2011-03-29
Name of individual signing DOUGLAS GORIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-03-29
Name of individual signing DOUGLAS GORIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
PERIODONTICS, LLC 401(K) PROFIT SHARING PLAN 2010 263078778 2011-04-12 PERIODONTICS, LLC 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 3126412572
Plan sponsor’s address 25 EAST WASHINGTON, SUITE 1125, CHICAGO, IL, 60602

Plan administrator’s name and address
Administrator’s EIN 263078778
Plan administrator’s name PERIODONTICS, LLC
Plan administrator’s address 25 EAST WASHINGTON, SUITE 1125, CHICAGO, IL, 60602
Administrator’s telephone number 3126412572

Signature of
Role Plan administrator
Date 2011-04-12
Name of individual signing DOUGLAS GORIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-04-12
Name of individual signing DOUGLAS GORIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
PERIODONTICS, LLC CASH BALANCE PLAN 2010 263078778 2011-02-25 PERIODONTICS, LLC 21
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 3126412572
Plan sponsor’s address 25 EAST WASHINGTON, SUITE 1125, CHICAGO, IL, 60602

Plan administrator’s name and address
Administrator’s EIN 263078778
Plan administrator’s name PERIODONTICS, LLC
Plan administrator’s address 25 EAST WASHINGTON, SUITE 1125, CHICAGO, IL, 60602
Administrator’s telephone number 3126412572

Signature of
Role Plan administrator
Date 2011-02-25
Name of individual signing DOUG GORIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-02-25
Name of individual signing DOUG GORIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
PERIODONTICS, LLC CASH BALANCE PLAN 2009 263078778 2010-09-10 PERIODONTICS, LLC 22
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 3126412572
Plan sponsor’s address 25 EAST WASHINGTON, SUITE 1125, CHICAGO, IL, 60602

Plan administrator’s name and address
Administrator’s EIN 263078778
Plan administrator’s name PERIODONTICS, LLC
Plan administrator’s address 25 EAST WASHINGTON, SUITE 1125, CHICAGO, IL, 60602
Administrator’s telephone number 3126412572

Signature of
Role Plan administrator
Date 2010-09-10
Name of individual signing DOUG GORIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-09-10
Name of individual signing DOUG GORIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
PERIODONTICS, LLC 401(K) PROFIT SHARING PLAN 2009 263078778 2010-10-15 PERIODONTICS, LLC 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 3126412572
Plan sponsor’s address 25 EAST WASHINGTON, SUITE 1125, CHICAGO, IL, 60602

Plan administrator’s name and address
Administrator’s EIN 263078778
Plan administrator’s name PERIODONTICS, LLC
Plan administrator’s address 25 EAST WASHINGTON, SUITE 1125, CHICAGO, IL, 60602
Administrator’s telephone number 3126412572

Signature of
Role Plan administrator
Date 2010-10-15
Name of individual signing DOUGLAS GORIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-15
Name of individual signing DOUGLAS GORIN, D.D.S.
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
WILLIAM R KUEHN, 102 N COOK ST, BARRINGTON, 60010 Agent 2009-03-11

Member

Name and Address Role Appointment Date
ALBERT SARNO TRUST, 461 HIGHWAY F, TWIN LAKES, WI, 53181 Member 2014-03-18
GEORGE SAVOY TRUST, 151 ROSE DRIVE, BLOOMINGDALE, IL, 60108 Member 2014-03-18

Related by officers

WILLIAM R KUEHN, 102 N COOK ST, BARRINGTON, 60010

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Related by address

No related companies by address

Date of last update: 16 Jan 2025

Sources: Illinois Office of the Secretary of State

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