0001209191-12-029084.txt : 20120518 0001209191-12-029084.hdr.sgml : 20120518 20120518061416 ACCESSION NUMBER: 0001209191-12-029084 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120515 FILED AS OF DATE: 20120518 DATE AS OF CHANGE: 20120518 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: 12853831 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 X0305 4 2012-05-15 0 0000811240 BIOLASE TECHNOLOGY INC BLTI 0001497166 Arrow Alexander K. C/O 4 CROMWELL IRVINE CA 92618 1 0 0 0 Common Stock 2012-05-15 4 A 0 2000 2.41 A 50775 D /s/ Michael C. Carroll, attorney-in-fact for Alexander K. Arrow 2012-05-17