PREMIER DENTAL, PLLC
|
2023
|
454154720
|
2024-07-29
|
PREMIER DENTAL, PLLC
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2017-10-01
|
Business code |
621210
|
Sponsor’s telephone number |
6068773002
|
Plan sponsor’s
address |
39 WACO DRIVE, LONDON, KY, 40741
|
Signature of
Role |
Plan administrator |
Date |
2024-07-29 |
Name of individual signing |
TERRI BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-07-29 |
Name of individual signing |
TERRI BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PREMIER DENTAL, PLLC
|
2022
|
454154720
|
2023-05-26
|
PREMIER DENTAL, PLLC
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2017-10-01
|
Business code |
621210
|
Sponsor’s telephone number |
6068773002
|
Plan sponsor’s
address |
39 WACO DRIVE, LONDON, KY, 40741
|
Signature of
Role |
Plan administrator |
Date |
2023-05-26 |
Name of individual signing |
DR. TERRI BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-05-26 |
Name of individual signing |
DR. TERRI BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PREMIER DENTAL, PLLC
|
2021
|
454154720
|
2022-05-09
|
PREMIER DENTAL, PLLC
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2017-10-01
|
Business code |
621210
|
Sponsor’s telephone number |
6068773002
|
Plan sponsor’s
address |
39 WACO DRIVE, LONDON, KY, 40741
|
Signature of
Role |
Plan administrator |
Date |
2022-05-05 |
Name of individual signing |
DR. TERRI BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-05-05 |
Name of individual signing |
DR. TERRI BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PREMIER DENTAL, PLLC
|
2020
|
454154720
|
2021-05-17
|
PREMIER DENTAL, PLLC
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2017-10-01
|
Business code |
621210
|
Sponsor’s telephone number |
6068773002
|
Plan sponsor’s
address |
39 WACO DRIVE, LONDON, KY, 40741
|
Signature of
Role |
Plan administrator |
Date |
2021-05-17 |
Name of individual signing |
TERRI BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-05-17 |
Name of individual signing |
TERRI BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PREMIER DENTAL, PLLC
|
2019
|
454154720
|
2020-07-15
|
PREMIER DENTAL, PLLC
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2017-10-01
|
Business code |
621210
|
Sponsor’s telephone number |
6068773002
|
Plan sponsor’s
address |
39 WACO DRIVE, LONDON, KY, 40741
|
Signature of
Role |
Plan administrator |
Date |
2020-07-15 |
Name of individual signing |
TERRI BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-07-15 |
Name of individual signing |
TERRI BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PREMIER DENTAL, PLLC
|
2018
|
454154720
|
2019-05-13
|
PREMIER DENTAL, PLLC
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2017-10-01
|
Business code |
621210
|
Sponsor’s telephone number |
6068773002
|
Plan sponsor’s
address |
39 WACO DRIVE, LONDON, KY, 40741
|
Signature of
Role |
Plan administrator |
Date |
2019-05-13 |
Name of individual signing |
TERRI BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-05-13 |
Name of individual signing |
TERRI BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PREMIER DENTAL, PLLC
|
2017
|
454154720
|
2018-03-13
|
PREMIER DENTAL, PLLC
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2017-10-01
|
Business code |
621210
|
Sponsor’s telephone number |
6068773002
|
Plan sponsor’s
address |
39 WACO DRIVE, LONDON, KY, 40741
|
Signature of
Role |
Plan administrator |
Date |
2018-03-13 |
Name of individual signing |
TERRI BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-03-13 |
Name of individual signing |
TERRI BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|