0001209191-17-052621.txt : 20170913
0001209191-17-052621.hdr.sgml : 20170913
20170913163709
ACCESSION NUMBER: 0001209191-17-052621
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170911
FILED AS OF DATE: 20170913
DATE AS OF CHANGE: 20170913
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: 171083487
MAIL ADDRESS:
STREET 1: 500 WEST MAIN ST.
CITY: LOUISVILLE
STATE: KY
ZIP: 40202
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
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2017-09-11
0
0000811240
BIOLASE, INC
BIOL
0001112980
LORD JONATHAN T MD
4 CROMWELL
IRVINE
CA
92618
1
0
0
0
Stock Option (right to buy)
0.54
2017-09-11
4
A
0
65385
0.00
A
2027-09-11
Common Stock
65385
492503
D
Stock Option (right to buy)
0.61
2017-09-12
4
A
0
65891
0.00
A
2027-09-12
Common Stock
65891
558394
D
The stock option vests and is exercisable in equal monthly installments over a consecutive 8-month period, commencing October 10, 2017.
/s/ Michael C. Carroll, attorney-in-fact for Jonathan T. Lord
2017-09-13