0001209191-22-028769.txt : 20220513 0001209191-22-028769.hdr.sgml : 20220513 20220513103600 ACCESSION NUMBER: 0001209191-22-028769 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220511 FILED AS OF DATE: 20220513 DATE AS OF CHANGE: 20220513 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Somerman Martha J. DDS, PhD CENTRAL INDEX KEY: 0001879393 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36385 FILM NUMBER: 22920870 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: 27042 TOWNE CENTRE DRIVE STREET 2: SUITE 270 CITY: FOOTHILL RANCH STATE: CA ZIP: 92610 BUSINESS PHONE: 949-361-1200 MAIL ADDRESS: STREET 1: 27042 TOWNE CENTRE DRIVE STREET 2: SUITE 270 CITY: FOOTHILL RANCH STATE: CA ZIP: 92610 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 2022-05-11 0 0000811240 BIOLASE, INC BIOL 0001879393 Somerman Martha J. DDS, PhD 27042 TOWNE CENTRE DR. SUITE 270 FOOTHILL RANCH CA 92610 1 0 0 0 Restricted Stock Unit 2022-05-11 4 A 0 42232 0.00 A Common Stock 42232 42232 D At the option of the Company, each restricted stock unit represents the right to receive, at settlement, one share of common stock, or its cash equivalent. The restricted stock unit award fully vests and is immediately exercisable upon the one year anniversary of the date of grant. /s/ Michael C. Carroll, attorney-in-fact for Martha Somerman 2022-05-13