-----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, A6ZgfHwDqVLOr1L5DdSzenkLempw8zeqnj0ynIVuyM+CzLJvewZgGSjKp9ihNreP VmPvdb6rA8p+tzmLwo7p3A== 0001209191-09-036488.txt : 20090714 0001209191-09-036488.hdr.sgml : 20090714 20090714195752 ACCESSION NUMBER: 0001209191-09-036488 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20090714 FILED AS OF DATE: 20090714 DATE AS OF CHANGE: 20090714 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Scott Brett L CENTRAL INDEX KEY: 0001405195 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19627 FILM NUMBER: 09944688 MAIL ADDRESS: STREET 1: 15770 LAGUNA CANYON ROAD STREET 2: SUITE 150 CITY: IRVINE STATE: CA ZIP: 92618 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: 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: 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 3 1 doc3.xml FORM 3 SUBMISSION X0203 3 2009-07-14 1 0000811240 BIOLASE TECHNOLOGY INC BLTI 0001405195 Scott Brett L 4 CROMWELL IRVINE CA 92618 0 1 0 0 Chief Financial Officer /s/ Michael C. Carroll, Attorney-in-Fact for Brett L. Scott 2009-07-14 EX-24.3_294160 2 poa.txt POA DOCUMENT LIMITED POWER OF ATTORNEY Know all by these presents, that the undersigned hereby authorizes Michael C. Carroll to execute for and on behalf of the undersigned, in the undersigned's capacity as a Section 16 reporting person of Biolase Technology, Inc., a Delaware corporation (the "Company"), EDGAR Form ID (including amendments thereto) and Authenticating Statements, Forms 3, 4 and 5, and any amendments thereto, and cause such form(s) to be filed with the United States Securities and Exchange Commission and The NASDAQ Stock Market. The undersigned hereby grants to such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorney-in-fact, in serving in such capacity at the request of the undersigned, is not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934, as amended or the rules promulgated thereunder. This Limited Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4 and 5 with respect to the undersigned's holdings of, and transactions in, securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorney-in-fact. IN WITNESS WHEREOF, the undersigned has cause this Power of Attorney to be executed as of this 14th day of July, 2009. By: /s/ Brett L. Scott Print Name: Brett L. Scott -----END PRIVACY-ENHANCED MESSAGE-----