0001209191-15-068587.txt : 20150831 0001209191-15-068587.hdr.sgml : 20150831 20150831145842 ACCESSION NUMBER: 0001209191-15-068587 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150827 FILED AS OF DATE: 20150831 DATE AS OF CHANGE: 20150831 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: LORD JONATHAN T MD CENTRAL INDEX KEY: 0001112980 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36385 FILM NUMBER: 151084635 MAIL ADDRESS: STREET 1: 500 WEST MAIN ST. CITY: LOUISVILLE STATE: KY ZIP: 40202 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2015-08-27 0 0000811240 BIOLASE, INC BIOL 0001112980 LORD JONATHAN T MD 4 CROMWELL IRVINE CA 92618 1 0 0 0 Common Stock 2015-08-27 4 M 0 9217 A 110380 D Restricted Stock Unit 2015-08-27 4 M 0 9217 0.00 D Common Stock 9217 0 D Restricted stock units covert into common stock on a one-for-one basis. On August 27, 2014, the reporting person was granted 9,217 restricted stock units, vesting on the first anniversary of the grant date. /s/ Michael C. Carroll, attorney-in-fact for Jonathan T. Lord. 2015-08-31