<SEC-DOCUMENT>0000905148-17-000667-index.html : 20170713 <SEC-HEADER>0000905148-17-000667.hdr.sgml : 20170713 <ACCEPTANCE-DATETIME>20170713171005 ACCESSION NUMBER: 0000905148-17-000667 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161229 FILED AS OF DATE: 20170713 DATE AS OF CHANGE: 20170713 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: 4 CROMWELL CITY: IRVINE STATE: CA ZIP: 92618 BUSINESS PHONE: 949-361-1200 MAIL ADDRESS: STREET 1: 4 CROMWELL CITY: IRVINE STATE: CA ZIP: 92618 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SCHULER JACK W CENTRAL INDEX KEY: 0001021412 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36385 FILM NUMBER: 17964063 MAIL ADDRESS: STREET 1: 100 N. FIELD DRIVE STREET 2: SUITE 360 CITY: LAKE FOREST STATE: IL ZIP: 60045 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jack W. Schuler Living Trust CENTRAL INDEX KEY: 0001661351 STATE OF INCORPORATION: IL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36385 FILM NUMBER: 17964064 BUSINESS ADDRESS: STREET 1: 100 NORTH FIELD DRIVE STREET 2: SUITE 360 CITY: LAKE FOREST STATE: IL ZIP: 60045 BUSINESS PHONE: 224-880-1210 MAIL ADDRESS: STREET 1: 100 NORTH FIELD DRIVE STREET 2: SUITE 360 CITY: LAKE FOREST STATE: IL ZIP: 60045 </SEC-HEADER> <DOCUMENT> <TYPE>4 <SEQUENCE>1 <FILENAME>form4.xml <TEXT> Document 1 - file: form4.html
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