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  5. MATT G. VANDERMOLEN, D.D.S., P.C.

MATT G. VANDERMOLEN, D.D.S., P.C.

Company Details

Entity Name: MATT G. VANDERMOLEN, D.D.S., P.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 30 Dec 2003
Date of Dissolution: 12 May 2023
Company Number: CORP_63292737
File Number: 63292737
Type of Business: Incorporated under the Medical Corporation Act
Date Status Change: 12 May 2023
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ADVANCED DENTAL CARE OF SPRINGFIELD 401(K) PLAN 2022 853276289 2023-08-29 ADVANCED DENTAL CARE OF SPRINGFIELD 31
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 2175463333
Plan sponsor’s address 4701 WABASH, SPRINGFIELD, IL, 62711
ADVANCED DENTAL CARE OF SPRINGFIELD 401(K) PLAN 2020 200593492 2021-09-10 MATT G. VANDERMOLEN, D.D.S., P.C. 26
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 2175463333
Plan sponsor’s address 2851 EAST LAKE SHORE DRIVE, SPRINGFIELD, IL, 62711
ADVANCED DENTAL CARE OF SPRINGFIELD 401(K) PLAN 2019 200593492 2020-03-31 MATT G. VANDERMOLEN, D.D.S., P.C. 27
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 2175463333
Plan sponsor’s address 4701 W. WABASH, SPRINGFIELD, IL, 62711

Signature of
Role Plan administrator
Date 2020-03-26
Name of individual signing MATT VANDERMOLEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-03-26
Name of individual signing MATT VANDERMOLEN
Valid signature Filed with authorized/valid electronic signature
ADVANCED DENTAL CARE OF SPRINGFIELD 401(K) PLAN 2018 200593492 2019-04-26 MATT G. VANDERMOLEN, D.D.S., P.C. 25
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 2175463333
Plan sponsor’s address 4701 W. WABASH, SPRINGFIELD, IL, 62711

Signature of
Role Plan administrator
Date 2019-04-24
Name of individual signing MATT VANDERMOLEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-04-24
Name of individual signing MATT VANDERMOLEN
Valid signature Filed with authorized/valid electronic signature
ADVANCED DENTAL CARE OF SPRINGFIELD 401(K) PLAN 2017 200593492 2018-05-09 MATT G. VANDERMOLEN, D.D.S., P.C. 25
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 2175463333
Plan sponsor’s address 4701 W. WABASH, SPRINGFIELD, IL, 62711

Signature of
Role Plan administrator
Date 2018-05-09
Name of individual signing MATT VANDERMOLEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-05-09
Name of individual signing MATT VANDERMOLEN
Valid signature Filed with authorized/valid electronic signature
ADVANCED DENTAL CARE OF SPRINGFIELD 401(K) PLAN 2016 200593492 2017-07-21 MATT G. VANDERMOLEN, D.D.S., P.C. 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 2175463333
Plan sponsor’s address 2851 E. LAKE SHORE DRIVE, SPRINGFIELD, IL, 62712

Signature of
Role Plan administrator
Date 2017-07-20
Name of individual signing MATT VANDERMOLEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-20
Name of individual signing MATT VANDERMOLEN
Valid signature Filed with authorized/valid electronic signature
ADVANCED DENTAL CARE OF SPRINGFIELD 401(K) PLAN 2015 200593492 2016-05-13 MATT G. VANDERMOLEN, D.D.S., P.C. 19
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 2175463333
Plan sponsor’s address 4701 W. WABASH, SPRINGFIELD, IL, 62711

Signature of
Role Plan administrator
Date 2016-05-11
Name of individual signing MATT VANDERMOLEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-05-11
Name of individual signing MATT VANDERMOLEN
Valid signature Filed with authorized/valid electronic signature
ADVANCED DENTAL CARE OF SPRINGFIELD 401(K) PLAN 2014 200593492 2015-09-17 MATT G. VANDERMOLEN, D.D.S., P.C. 22
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 2175463333
Plan sponsor’s address 4701 W. WABASH, SPRINGFIELD, IL, 62711

Signature of
Role Plan administrator
Date 2015-09-16
Name of individual signing MATT VANDERMOLEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-09-16
Name of individual signing MATT VANDERMOLEN
Valid signature Filed with authorized/valid electronic signature
ADVANCED DENTAL CARE OF SPRINGFIELD 401(K) PLAN 2013 200593492 2014-05-21 MATT G. VANDERMOLEN, D.D.S., P.C. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 2175463333
Plan sponsor’s address 4701 W. WABASH, SPRINGFIELD, IL, 62711

Signature of
Role Plan administrator
Date 2014-05-21
Name of individual signing MATT VANDERMOLEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-05-21
Name of individual signing MATT VANDERMOLEN
Valid signature Filed with authorized/valid electronic signature
ADVANCED DENTAL CARE OF SPRINGFIELD 401(K) PLAN 2012 200593492 2013-06-28 MATT G. VANDERMOLEN, D.D.S., P.C. 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 2175463333
Plan sponsor’s address 4701 W. WABASH, SPRINGFIELD, IL, 62711

Signature of
Role Plan administrator
Date 2013-06-26
Name of individual signing MATT VANDERMOLEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-06-26
Name of individual signing MATT VANDERMOLEN
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
MATT VANDERMOLEN, 2851 E LAKE SHORE DR, SPRINGFIELD, 62712, SANGAMON Agent 2019-08-30

President

Name and Address Role
MATT G VANDERMOLEN 2851 E LAKE DR SPRINGFIELD 62707 President

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
ADVANCED DENTAL CARE OF SPRINGFIELD No data 2003-12-30 2023-05-01 Involuntary Cancellation No data

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 1000 100000 No data

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 23 Dec 2024

Sources: Illinois Office of the Secretary of State

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