0001209191-12-042048.txt : 20120815 0001209191-12-042048.hdr.sgml : 20120815 20120815193310 ACCESSION NUMBER: 0001209191-12-042048 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120814 FILED AS OF DATE: 20120815 DATE AS OF CHANGE: 20120815 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: 121038320 MAIL ADDRESS: STREET 1: PO BOX 3094 CITY: REDWOOD CITY STATE: CA ZIP: 94064 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BIOLASE, 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: BIOLASE TECHNOLOGY INC DATE OF NAME CHANGE: 19941117 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 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2012-08-14 0 0000811240 BIOLASE, INC BLTI 0001497166 Arrow Alexander K. C/O 4 CROMWELL IRVINE CA 92618 1 0 0 0 Common Stock 2012-08-14 4 P 0 1363 1.71 A 93998 D Common Stock 2012-08-14 4 P 0 1100 1.72 A 95038 D Common Stock 2012-08-14 4 P 0 1237 1.73 A 96275 D Common Stock 2012-08-14 4 P 0 377 1.70 A 96652 D Common Stock 2012-08-14 4 P 0 4800 1.67 A 101452 D Common Stock 2012-08-14 4 P 0 723 1.68 A 102175 D Common Stock 2012-08-14 4 P 0 400 1.69 A 102575 D /s/ Michael C. Carroll, attorney-in-fact for Alexander K. Arrow 2012-08-15