0001209191-17-031221.txt : 20170510
0001209191-17-031221.hdr.sgml : 20170510
20170510160912
ACCESSION NUMBER: 0001209191-17-031221
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170508
FILED AS OF DATE: 20170510
DATE AS OF CHANGE: 20170510
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: MOLL FREDERIC H
CENTRAL INDEX KEY: 0001260157
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36385
FILM NUMBER: 17830295
MAIL ADDRESS:
STREET 1: C/O INTUITIVE SURGICAL INC
STREET 2: 950 KIFER ROAD
CITY: SUNNYVALE
STATE: CA
ZIP: 94086
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2017-05-08
0
0000811240
BIOLASE, INC
BIOL
0001260157
MOLL FREDERIC H
4 CROMWELL
IRVINE
CA
92618
1
0
0
0
Common Stock
2017-05-08
4
M
0
50000
A
59217
D
Restricted Stock Unit
2017-05-08
4
M
0
50000
0.00
D
Common Stock
50000
0
D
Each restricted stock unit represents the right to receive, at settlement, one share of common stock.
On May 6, 2016, the reporting person was granted 50,000 restricted stock units, which vested on May 6, 2017.
/s/ Michael C. Carroll, attorney-in-fact for Frederic H. Moll
2017-05-10