0001209191-17-031917.txt : 20170512
0001209191-17-031917.hdr.sgml : 20170512
20170512161406
ACCESSION NUMBER: 0001209191-17-031917
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170510
FILED AS OF DATE: 20170512
DATE AS OF CHANGE: 20170512
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: 17838787
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
2017-05-10
0
0000811240
BIOLASE, INC
BIOL
0001222248
CLARK PAUL N
4 CROMWELL
IRVINE
CA
92603
1
0
0
0
Stock Option (right to buy)
1.21
2017-05-10
4
A
0
203345
0.00
A
2027-05-10
Common Stock
203345
754221
D
Restricted Stock Unit
2017-05-10
4
A
0
67782
0.00
A
Common Stock
67782
67782
D
The stock option vests and is exercisable in equal monthly installments over a consecutive 12-month period, commencing one month from the date of grant.
Each restricted stock unit represents the right to receive, at settlement, one share of common stock.
The restricted stock unit award fully vests and is immediately exercisable on the first anniversary of the date of the award.
/s/ Michael C. Carroll, attorney-in-fact for Paul N. Clark
2017-05-12