0001209191-18-054479.txt : 20181009 0001209191-18-054479.hdr.sgml : 20181009 20181009120623 ACCESSION NUMBER: 0001209191-18-054479 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181008 FILED AS OF DATE: 20181009 DATE AS OF CHANGE: 20181009 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Wagner Elaine C CENTRAL INDEX KEY: 0001755150 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36385 FILM NUMBER: 181112934 MAIL ADDRESS: STREET 1: 7621 HUNTMASTER LANE CITY: MCLEAN STATE: VA ZIP: 22102 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 2018-10-08 0 0000811240 BIOLASE, INC BIOL 0001755150 Wagner Elaine C 4 CROMWELL IRVINE CA 92618 1 0 0 0 Restricted Stock Unit 2018-10-08 4 A 0 44374 0.00 A Common Stock 44374 44374 D Each restricted stock unit represents the right to receive, at settlement, one share of common stock. The restricted stock unit award fully vests on May 9, 2019. /s/ Michael C. Carroll, attorney-in-fact for Elaine C. Wagner 2018-10-09