0001209191-14-066756.txt : 20141105 0001209191-14-066756.hdr.sgml : 20141105 20141105180745 ACCESSION NUMBER: 0001209191-14-066756 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20141103 FILED AS OF DATE: 20141105 DATE AS OF CHANGE: 20141105 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Nugent Jeffrey M CENTRAL INDEX KEY: 0001455940 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36385 FILM NUMBER: 141198117 MAIL ADDRESS: STREET 1: 1875 SOUTH GRANT STREET, SUITE 110 CITY: SAN MATEO STATE: CA ZIP: 94402 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2014-11-03 0 0000811240 BIOLASE, INC BIOL 0001455940 Nugent Jeffrey M C/O BIOLASE, INC., 4 CROMWELL IRVINE CA 92618 1 1 0 0 Chief Executive Officer Common Stock 2014-11-03 4 P 0 40465 2.39 A 92548 D Warrants (right to buy) 4.00 2014-11-03 4 P 0 26302 0.125 A 2015-05-07 2017-11-07 Common Stock 26302 26302 D /s/ Michael C. Carroll, attorney-in-fact 2014-11-05