0001209191-12-018171.txt : 20120314
0001209191-12-018171.hdr.sgml : 20120314
20120314142727
ACCESSION NUMBER: 0001209191-12-018171
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120313
FILED AS OF DATE: 20120314
DATE AS OF CHANGE: 20120314
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: PIGNATELLI FEDERICO
CENTRAL INDEX KEY: 0001270560
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-19627
FILM NUMBER: 12689966
MAIL ADDRESS:
STREET 1: BIOLASE TECHNOLOGY INC
STREET 2: 4 CROMWELL
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
4
1
doc4.xml
FORM 4 SUBMISSION
X0304
4
2012-03-13
0
0000811240
BIOLASE TECHNOLOGY INC
BLTI
0001270560
PIGNATELLI FEDERICO
4 CROMWELL
IRVINE
CA
92618
1
1
0
0
Chairman and CEO
Common Stock
2012-03-13
4
M
0
100000
2.58
A
1725250
D
Stock Option (right to buy)
2.54
2012-03-13
4
M
0
100000
2.54
D
2012-03-02
2018-12-23
Common Stock
100000
200000
D
/s/ Michael C. Carroll, Attorney-in-fact for Federico Pignatelli
2012-03-14