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  5. HARDIN COUNTY PHARMACY, LLC

HARDIN COUNTY PHARMACY, LLC

Company Details

Entity Name: HARDIN COUNTY PHARMACY, LLC
Jurisdiction: Illinois
Entity Type: Limited Liability Company
Status: Goodstanding
Date Formed: 19 Aug 2016
Company Number: LLC_05929318
File Number: 05929318
Type of Management: Member Managed
Date Status Change: 03 Jul 2024
Address 7 FERRELL ROAD, ROSICLARE, 62982, IL
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HARDIN COUNTY PHARMACY LLC 401(K) PLAN 2023 813677479 2024-07-30 HARDIN COUNTY PHARMACY LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 446110
Sponsor’s telephone number 6182856618
Plan sponsor’s address 7 FERRELL ROAD, ROSICLARE, IL, 62982

Signature of
Role Plan administrator
Date 2024-07-29
Name of individual signing AMANDA ETIENNE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-07-29
Name of individual signing AMANDA ETIENNE
Valid signature Filed with authorized/valid electronic signature
HARDIN COUNTY PHARMACY LLC CASH BALANCE PLAN 2023 813677479 2024-06-05 HARDIN COUNTY PHARMACY LLC 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2023-01-01
Business code 446110
Sponsor’s telephone number 6182856618
Plan sponsor’s address 7 FERRELL ROAD, ROSICLARE, IL, 62982

Signature of
Role Plan administrator
Date 2024-06-04
Name of individual signing AMANDA ETIENNE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-06-04
Name of individual signing AMANDA ETIENNE
Valid signature Filed with authorized/valid electronic signature
HARDIN COUNTY PHARMACY LLC 401(K) PLAN 2022 813677479 2023-07-25 HARDIN COUNTY PHARMACY LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 446110
Sponsor’s telephone number 6182856618
Plan sponsor’s address 7 FERRELL ROAD, ROSICLARE, IL, 62982

Signature of
Role Plan administrator
Date 2023-07-24
Name of individual signing AMANDA ETIENNE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-07-24
Name of individual signing AMANDA ETIENNE
Valid signature Filed with authorized/valid electronic signature
HARDIN COUNTY PHARMACY LLC 401(K) PLAN 2021 813677479 2022-06-16 HARDIN COUNTY PHARMACY LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 446110
Sponsor’s telephone number 6182856618
Plan sponsor’s address 7 FERRELL ROAD, ROSICLARE, IL, 62982

Signature of
Role Plan administrator
Date 2022-06-15
Name of individual signing AMANDA ETIENNE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-06-15
Name of individual signing AMANDA ETIENNE
Valid signature Filed with authorized/valid electronic signature
HARDIN COUNTY PHARMACY LLC 401(K) PLAN 2020 813677479 2021-06-25 HARDIN COUNTY PHARMACY LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 446110
Sponsor’s telephone number 6182856618
Plan sponsor’s address 7 FERRELL ROAD, ROSICLARE, IL, 62982

Signature of
Role Plan administrator
Date 2021-06-25
Name of individual signing AMANDA ETIENNE
Valid signature Filed with authorized/valid electronic signature
HARDIN COUNTY PHARMACY LLC 401(K) PLAN 2019 813677479 2020-06-05 HARDIN COUNTY PHARMACY LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 446110
Sponsor’s telephone number 6182856618
Plan sponsor’s address 7 FERRELL ROAD, ROSICLARE, IL, 62982

Signature of
Role Plan administrator
Date 2020-06-05
Name of individual signing AMANDA ETIENNE
Valid signature Filed with authorized/valid electronic signature
HARDIN COUNTY PHARMACY LLC 401(K) PLAN 2018 813677479 2019-05-24 HARDIN COUNTY PHARMACY LLC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 446110
Sponsor’s telephone number 6182856618
Plan sponsor’s address 7 FERRELL ROAD, ROSICLARE, IL, 62982

Signature of
Role Plan administrator
Date 2019-05-24
Name of individual signing AMANDA ETIENNE
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
TIMOTHY SCOTT ETIENNE, 1010 BIXLER RD, ELDORADO, 62930 Agent 2016-08-19

Manager

Name and Address Role Appointment Date
ETIENNE, AMANDA LEA, 1010 BIXLER RD, ELDORDO, IL, 62930 Manager 2024-07-03
ETIENNE, TIMOTHY SCOTT, 1010 BIXLER RD, ELDORADO, IL, 62930 Manager 2024-07-03

License

License Type License Number Status License Code License Description Business Activity Date Issued Effective Date Expiration Date
PHARMACY 054020682 No data No data LICENSED PHARMACY No data 2018-04-16 2024-01-12 2026-03-31
PHARMACY 054020393 No data No data LICENSED PHARMACY No data 2017-07-12 2024-01-12 2026-03-31

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
GOLCONDA PHARMACY Assumed name 2017-12-14 No data No data 2020-07-09

Related by officers

TIMOTHY SCOTT ETIENNE, 1010 BIXLER RD, ELDORADO, 62930

TSE AGENCY LLC

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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