-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, FhhHV6VmlaJa0i0AFIn4SJE6bPiPQ3xBhjh0WaglVCdmmzjz+JgLLAPG9du7N3oo zW8TkFbzgPzl+YD09cbJ9Q== 0001019687-04-001689.txt : 20040804 0001019687-04-001689.hdr.sgml : 20040804 20040804200702 ACCESSION NUMBER: 0001019687-04-001689 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040803 FILED AS OF DATE: 20040804 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Grant Robert E CENTRAL INDEX KEY: 0001293753 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19627 FILM NUMBER: 04952921 BUSINESS ADDRESS: BUSINESS PHONE: 949-361-1200 MAIL ADDRESS: STREET 1: C/O BIOLASE TECHNOLOGY, INC. STREET 2: 981 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92673 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BIOLASE TECHNOLOGY 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: 981 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92673 BUSINESS PHONE: 7143611200 MAIL ADDRESS: STREET 1: 981 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92673 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 FORMER COMPANY: FORMER CONFORMED NAME: PAMPLONA CAPITAL CORP DATE OF NAME CHANGE: 19911104 4 1 edgar.xml PRIMARY DOCUMENT X0202 4 2004-08-03 0000811240 BIOLASE TECHNOLOGY INC BLTI 0001293753 Grant Robert E 981 CALLE AMANECER SAN CLEMENTE CA 92673 0 1 0 0 VP and COO Common Stock (owned) 0 D Common Stock 2004-08-03 4 P 0 1000 8.86 A 1000 D 6/20/03 Option to Purchase Common Stock 11.61 2003-06-20 4 A 0 10000 A 2004-06-20 2013-06-20 Common Stock 10000 10000 D 8/8/03 Option to Purchase Common Stock 11.02 2003-08-08 4 A 0 10000 A 2004-08-03 2013-08-08 Common Stock 90000 90000 D Options granted under the Company's 2002 Stock Incentive Plan, a plan meeting the requirements of 16b-3. Not applicable. Robert Grant 2004-08-03 -----END PRIVACY-ENHANCED MESSAGE-----