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  5. ANDRIS FAMILY DENTAL, PLLC

ANDRIS FAMILY DENTAL, PLLC

Company Details

Entity Name: ANDRIS FAMILY DENTAL, PLLC
Jurisdiction: Illinois
Entity Type: Limited Liability Company
Status: Goodstanding
Date Formed: 28 Oct 2015
Company Number: LLC_05480981
File Number: 05480981
Type of Management: Manager Managed
Date Status Change: 17 Sep 2024
Address 636 W. JEFFERSON ST., MORTON, 61550, IL
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ANDRIS FAMILY DENTAL, LLC 401(K) PROFIT SHARING PLAN 2023 475505078 2024-07-08 ANDRIS FAMILY DENTAL, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 3092638317
Plan sponsor’s address 636 W. JEFFERSON ST., MORTON, IL, 61550
ANDRIS FAMILY DENTAL, LLC 401(K) PROFIT SHARING PLAN 2022 475505078 2023-02-20 ANDRIS FAMILY DENTAL, LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 3092638317
Plan sponsor’s address 636 W. JEFFERSON ST., MORTON, IL, 61550

Signature of
Role Plan administrator
Date 2023-02-17
Name of individual signing RYAN ANDRIS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-02-17
Name of individual signing RYAN ANDRIS
Valid signature Filed with authorized/valid electronic signature
ANDRIS FAMILY DENTAL, LLC 401(K) PROFIT SHARING PLAN 2021 475505078 2022-05-03 ANDRIS FAMILY DENTAL, LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 3092638317
Plan sponsor’s address 636 W. JEFFERSON ST., MORTON, IL, 61550

Signature of
Role Plan administrator
Date 2022-04-30
Name of individual signing RYAN ANDRIS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-04-30
Name of individual signing RYAN ANDRIS
Valid signature Filed with authorized/valid electronic signature
ANDRIS FAMILY DENTAL, LLC 401(K) PROFIT SHARING PLAN 2020 475505078 2021-04-25 ANDRIS FAMILY DENTAL, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 3092638317
Plan sponsor’s address 636 W. JEFFERSON ST., MORTON, IL, 61550

Signature of
Role Plan administrator
Date 2021-04-09
Name of individual signing RYAN ANDRIS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-09
Name of individual signing RYAN ANDRIS
Valid signature Filed with authorized/valid electronic signature
ANDRIS FAMILY DENTAL, LLC 401(K) PROFIT SHARING PLAN 2019 475505078 2020-06-30 ANDRIS FAMILY DENTAL, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 3092638317
Plan sponsor’s address 636 W. JEFFERSON ST., MORTON, IL, 61550

Signature of
Role Plan administrator
Date 2020-06-19
Name of individual signing RYAN ANDRIS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-06-19
Name of individual signing RYAN ANDRIS
Valid signature Filed with authorized/valid electronic signature
ANDRIS FAMILY DENTAL, LLC 401(K) PROFIT SHARING PLAN 2018 475505078 2019-04-12 ANDRIS FAMILY DENTAL, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 3092638317
Plan sponsor’s address 636 W. JEFFERSON ST., MORTON, IL, 61550

Signature of
Role Plan administrator
Date 2019-04-12
Name of individual signing RYAN ANDRIS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-04-12
Name of individual signing RYAN ANDRIS
Valid signature Filed with authorized/valid electronic signature
ANDRIS FAMILY DENTAL, LLC 401(K) PROFIT SHARING PLAN 2017 475505078 2018-05-08 ANDRIS FAMILY DENTAL, LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 3092638317
Plan sponsor’s address 636 W. JEFFERSON ST., MORTON, IL, 615501581
ANDRIS FAMILY DENTAL, LLC 401(K) PROFIT SHARING PLAN 2016 475505078 2017-06-15 ANDRIS FAMILY DENTAL, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 3092638317
Plan sponsor’s address 636 W. JEFFERSON ST., MORTON, IL, 61550

Agent

Name and Address Role Appointment Date
PATRICK R. COX, 202 N. CENTER, BLOOMINGTON, 61701 Agent 2015-10-28

Manager

Name and Address Role Appointment Date
ANDRIS, RYAN D.M.D., 636 W. JEFFERSON ST., MORTON, IL, 61550 Manager 2024-09-17

Historical Names

Name Change Date
ANDRIS FAMILY DENTAL, LLC 2019-08-22

Related by officers

PATRICK R. COX, 202 N. CENTER, BLOOMINGTON, 61701

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Related by address

No related companies by address

Date of last update: 27 Jan 2025

Sources: Illinois Office of the Secretary of State

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