0001209191-21-053507.txt : 20210826
0001209191-21-053507.hdr.sgml : 20210826
20210826171659
ACCESSION NUMBER: 0001209191-21-053507
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210812
FILED AS OF DATE: 20210826
DATE AS OF CHANGE: 20210826
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: OLoughlin Kathleen T
CENTRAL INDEX KEY: 0001880417
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36385
FILM NUMBER: 211213293
MAIL ADDRESS:
STREET 1: 27042 TOWN CENTRE DRIVE
STREET 2: SUITE 270
CITY: FOOTHILL RANCH
STATE: CA
ZIP: 92610
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
2021-08-12
0
0000811240
BIOLASE, INC
BIOL
0001880417
OLoughlin Kathleen T
27042 TOWNE CENTRE DR.
SUITE 270
FOOTHILL RANCH
CA
92610
1
0
0
0
Stock Appreciation Right
0.63
2021-08-12
4
A
0
98955
0.00
A
2031-08-12
Common Stock
98955
98955
D
Of the stock appreciation rights subject to this SAR, the stock appreciation rights vest on May 26, 2022.
/s/ Michael C. Carroll, attorney-in-fact for Kathleen T. O'Loughlin
2021-08-22