CEDAR CREEK DENTAL, PLLC

Company Details

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

CEDAR CREEK DENTAL PLLC 401(K) PLAN

2023

883946808

2024-07-10

CEDAR CREEK DENTAL PLLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1999-07-01
Business code	621210
Sponsor’s telephone number	6186544551
Plan sponsor’s address	380 SUPPIGER WAY, SUITE 3, HIGHLAND, IL, 62249

Signature of

Role	Plan administrator
Date	2024-07-10
Name of individual signing	JARED CRUTCHER
Valid signature	Filed with authorized/valid electronic signature

CEDAR CREEK DENTAL, PLLC. 401(K) PLAN

2022

883946808

2023-05-30

CEDAR CREEK DENTAL, PLLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1999-07-01
Business code	621210
Sponsor’s telephone number	6186544551
Plan sponsor’s address	380 SUPPIGER WAY, SUITE 3, HIGHLAND, IL, 622490057

Signature of

Role	Plan administrator
Date	2023-05-30
Name of individual signing	JARED CRUTCHER
Valid signature	Filed with authorized/valid electronic signature

Name and Address	Role	Appointment Date
CHRISTOPHER W. BYRON, 411 ST. LOUIS STREET, EDWARDSVILLE, 62025	Agent	2022-08-25

Name and Address	Role	Appointment Date
JARED CRUTCHER, 380 SUPPIGER WAY #3, HIGHLAND, IL, 62249	Manager	2022-08-25

License Type	License Number	Status	License Code	License Description	Business Activity	Date Issued	Effective Date	Expiration Date
LIMITED LIABILITY CO	248004871	No data	No data	PROFESSIONAL LIMITED LIABILITY COMPANY	No data	2024-05-03	2024-05-03	2025-01-01

Date of last update: 16 Jan 2025