| Entity Name: | MATTHEW LIESEN, DMD, PLLC |
| Jurisdiction: | Illinois |
| Entity Type: | Limited Liability Company |
| Status: | Goodstanding |
| Date Formed: | 24 Jun 2021 |
| Company Number: | LLC_10024862 |
| File Number: | 10024862 |
| Type of Management: | Manager Managed |
| Date Status Change: | 20 May 2024 |
| Address | 3 COLLINSPORT DRIVE, COLLINSVILLE, 62234, IL |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LIESEN FAMILY DENTAL 401(K) PLAN | 2023 | 871385444 | 2024-10-01 | MATTHEW LIESEN DMD PLLC | 7 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-10-01 |
| Name of individual signing | MICHAEL VANDERFORD |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| PARKER C MATHERS, 930 NORTH YORK ROAD STE #200, HINSDALE, 60521 | Agent | 2021-06-24 |
| Name and Address | Role | Appointment Date |
|---|---|---|
| MATTHEW LIESEN, 3 COLLINSPORT DR, COLLINSVILLE, IL, 62234 | Manager | 2024-05-20 |
Date of last update: 27 Jan 2025
