0001209191-15-079781.txt : 20151112 0001209191-15-079781.hdr.sgml : 20151112 20151112173016 ACCESSION NUMBER: 0001209191-15-079781 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151109 FILED AS OF DATE: 20151112 DATE AS OF CHANGE: 20151112 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: CLARK PAUL N CENTRAL INDEX KEY: 0001222248 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36385 FILM NUMBER: 151226057 MAIL ADDRESS: STREET 1: 5301 STEVENS CREEK BLVD STREET 2: MS 1A-LC CITY: SANTA CLARA STATE: CA ZIP: 95051 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2015-11-09 0 0000811240 BIOLASE, INC BIOL 0001222248 CLARK PAUL N 4 CROMWELL IRVINE CA 92603 1 0 0 0 Common Stock, par value $0.001 per share 2015-11-09 4 P 0 11646 0.75 A 1032324 I By Trust Common Stock, par value $0.001 per share 2015-11-09 4 P 0 7000 0.76 A 1039324 I By Trust Common Stock, par value $0.001 per share 2015-11-09 4 P 0 2800 0.77 A 1042124 I By Trust Common Stock, par value $0.001 per share 2015-11-09 4 P 0 2923 0.78 A 1045047 I By Trust Common Stock, par value $0.001 per share 2015-11-09 4 P 0 10210 0.79 A 1055257 I By Trust Common Stock, par value $0.001 per share 2015-11-10 4 P 0 4300 0.73 A 1059557 I By Trust Common Stock, par value $0.001 per share 2015-11-10 4 P 0 39699 0.74 A 1099256 I By Trust Common Stock, par value $0.001 per share 2015-11-10 4 P 0 23501 0.75 A 1122757 I By Trust Common Stock, par value $0.001 per share 2015-11-10 4 P 0 32500 0.76 A 1155257 I By Trust /s/ Michael C. Carroll, attorney-in-fact for Paul N. Clark 2015-11-11