0001209191-11-045233.txt : 20110822
0001209191-11-045233.hdr.sgml : 20110822
20110822172330
ACCESSION NUMBER: 0001209191-11-045233
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20110818
FILED AS OF DATE: 20110822
DATE AS OF CHANGE: 20110822
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Arrow Alexander K.
CENTRAL INDEX KEY: 0001497166
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-19627
FILM NUMBER: 111050586
MAIL ADDRESS:
STREET 1: PO BOX 3094
CITY: REDWOOD CITY
STATE: CA
ZIP: 94064
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
4
1
doc4.xml
FORM 4 SUBMISSION
X0304
4
2011-08-18
0
0000811240
BIOLASE TECHNOLOGY INC
BLTI
0001497166
Arrow Alexander K.
C/O 4 CROMWELL
IRVINE
CA
92618
1
0
0
0
Common Stock
2011-08-18
4
P
0
5000
2.84
A
48775
D
Includes 275 shares which were received from Biolase Technology, Inc. as stock dividends, consisting of 30 shares received on March 31, 2011 and 245 shares received on June 30, 2011.
/s/ Michael C. Carroll, Attorney-in-Fact for Alexander K. Arrow
2011-08-22