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CARLSON DENTISTRY LLC

CARLSON DENTISTRY LLC

Company Details

Entity Name:	CARLSON DENTISTRY LLC
Jurisdiction:	Illinois
Entity Type:	Limited Liability Company
Status:	Goodstanding
Date Formed:	26 Jun 2018
Company Number:	LLC_07048939
File Number:	07048939
Type of Management:	Manager Managed
Date Status Change:	29 Apr 2024
Address	419 N. MULFORD ROAD, SUITE 4, ROCKFORD, 61107, IL
Place of Formation:	ILLINOIS

form 5500

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

CARLSON DENTISTRY LLC 401(K) PLAN

2023

831048417

2024-02-12

CARLSON DENTISTRY LLC

6

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2018-11-01
Business code	621210
Sponsor’s telephone number	8153941222
Plan sponsor’s address	419 N. MULFORD ROAD, #4, ROCKFORD, IL, 61107

CARLSON DENTISTRY LLC 401(K) PLAN

2022

831048417

2023-01-27

CARLSON DENTISTRY LLC

6

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2018-11-01
Business code	621210
Sponsor’s telephone number	8153941222
Plan sponsor’s address	419 N. MULFORD ROAD, #4, ROCKFORD, IL, 61107

CARLSON DENTISTRY LLC 401(K) PLAN

2021

831048417

2022-03-24

CARLSON DENTISTRY LLC

6

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2018-11-01
Business code	621210
Sponsor’s telephone number	8153941222
Plan sponsor’s address	419 N. MULFORD ROAD, #4, ROCKFORD, IL, 61107

CARLSON DENTISTRY LLC 401(K) PLAN

2020

831048417

2021-02-22

CARLSON DENTISTRY LLC

7

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2018-11-01
Business code	621210
Sponsor’s telephone number	8153941222
Plan sponsor’s address	419 N. MULFORD ROAD, #4, ROCKFORD, IL, 61107

CARLSON DENTISTRY LLC 401(K) PLAN

2019

831048417

2020-05-12

CARLSON DENTISTRY LLC

7

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2018-11-01
Business code	621210
Sponsor’s telephone number	8153941222
Plan sponsor’s address	419 N. MULFORD ROAD, #4, ROCKFORD, IL, 61107

CARLSON DENTISTRY LLC 401(K) PLAN

2018

831048417

2019-03-12

CARLSON DENTISTRY LLC

7

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2018-11-01
Business code	621210
Sponsor’s telephone number	8153941222
Plan sponsor’s address	419 N. MULFORD ROAD, #4, ROCKFORD, IL, 61107

Agent

Name and Address	Role	Appointment Date
JASON J. CARLSON, D.M.D., 419 N MULFORD RD STE 4, ROCKFORD, 61107	Agent	2018-06-26

Manager

Name and Address	Role	Appointment Date
CARLSON, JASON J. (D.M.D.), 419 N. MULFORD ROAD, SUITE 4, ROCKFORD, IL, 61107	Manager	2024-04-29

License

License Type	License Number	Status	License Code	License Description	Business Activity	Date Issued	Effective Date	Expiration Date
LIMITED LIABILITY CO	248002312	No data	No data	PROFESSIONAL LIMITED LIABILITY COMPANY	No data	2018-08-16	2021-10-29	2025-01-01

Date of last update: 16 Jan 2025

Sources: Illinois Office of the Secretary of State