0001209191-21-070069.txt : 20211216
0001209191-21-070069.hdr.sgml : 20211216
20211216183852
ACCESSION NUMBER: 0001209191-21-070069
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211215
FILED AS OF DATE: 20211216
DATE AS OF CHANGE: 20211216
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: LORD JONATHAN T MD
CENTRAL INDEX KEY: 0001112980
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36385
FILM NUMBER: 211499078
MAIL ADDRESS:
STREET 1: 500 WEST MAIN ST.
CITY: LOUISVILLE
STATE: KY
ZIP: 40202
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: BIOLASE, INC
CENTRAL INDEX KEY: 0000811240
STANDARD INDUSTRIAL CLASSIFICATION: DENTAL EQUIPMENT & SUPPLIES [3843]
IRS NUMBER: 870442441
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 27042 TOWNE CENTRE DRIVE
STREET 2: SUITE 270
CITY: FOOTHILL RANCH
STATE: CA
ZIP: 92610
BUSINESS PHONE: 949-361-1200
MAIL ADDRESS:
STREET 1: 27042 TOWNE CENTRE DRIVE
STREET 2: SUITE 270
CITY: FOOTHILL RANCH
STATE: CA
ZIP: 92610
FORMER COMPANY:
FORMER CONFORMED NAME: BIOLASE TECHNOLOGY INC
DATE OF NAME CHANGE: 19941117
FORMER COMPANY:
FORMER CONFORMED NAME: LASER MEDICAL TECHNOLOGY INC
DATE OF NAME CHANGE: 19941117
FORMER COMPANY:
FORMER CONFORMED NAME: LASER ENDO TECHNIC CORP
DATE OF NAME CHANGE: 19920708
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-12-15
0
0000811240
BIOLASE, INC
BIOL
0001112980
LORD JONATHAN T MD
27042 TOWNE CENTRE DR.
SUITE 270
FOOTHILL RANCH
CA
92610
1
0
0
0
Common Stock
2021-12-15
4
S
0
11038
0.38
D
633096
D
/s/ Michael C. Carroll, attorney-in-fact for Jonathan T. Lord
2021-12-16