|
LAKEVIEW ENDODONTICS 401(K) PLAN
|
2023
|
464302015
|
2024-09-26
|
LAKEVIEW ENDODONTICS LLC
|
9
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
3128181918
|
| Plan sponsor’s
address |
3753 N. CLARK ST., CHICAGO, IL, 60613
|
Signature of
| Role |
Plan administrator |
| Date |
2024-09-26 |
| Name of individual signing |
MINDY VAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LAKEVIEW ENDODONTICS 401(K) PLAN
|
2022
|
464302015
|
2023-07-28
|
LAKEVIEW ENDODONTICS LLC
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
3128181918
|
| Plan sponsor’s
address |
3555 N ASHLAND AVE., SUITE 1, CHICAGO, IL, 60657
|
Signature of
| Role |
Plan administrator |
| Date |
2023-07-28 |
| Name of individual signing |
MINDY VAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2023-07-28 |
| Name of individual signing |
MINDY VAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LAKEVIEW ENDODONTICS 401(K) PLAN
|
2021
|
464302015
|
2022-09-21
|
LAKEVIEW ENDODONTICS LLC
|
5
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
3128181918
|
| Plan sponsor’s
address |
3555 N ASHLAND AVE. SUITE 1, CHICAGO, IL, 60657
|
Signature of
| Role |
Plan administrator |
| Date |
2022-09-21 |
| Name of individual signing |
MINDY VAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LAKEVIEW ENDODONTICS 401(K) PLAN
|
2020
|
464302015
|
2021-07-25
|
LAKEVIEW ENDODONTICS LLC
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
3128181918
|
| Plan sponsor’s
address |
3555 N ASHLAND AVE. SUITE 1, CHICAGO, IL, 60657
|
Signature of
| Role |
Plan administrator |
| Date |
2021-07-25 |
| Name of individual signing |
MINDY VAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
LAKEVIEW ENDODONTICS 401(K) PLAN
|
2019
|
464302015
|
2020-10-15
|
LAKEVIEW ENDODONTICS LLC
|
3
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2019-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
3128181918
|
| Plan sponsor’s
address |
3555 N. ASHLAND AVE., SUITE 1, CHICAGO, IL, 60657
|
Signature of
| Role |
Plan administrator |
| Date |
2020-10-15 |
| Name of individual signing |
DR. MINDY VAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
