0001209191-23-036142.txt : 20230612 0001209191-23-036142.hdr.sgml : 20230612 20230612085759 ACCESSION NUMBER: 0001209191-23-036142 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230608 FILED AS OF DATE: 20230612 DATE AS OF CHANGE: 20230612 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: 231007200 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: 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 X0407 4 2023-06-08 0 0000811240 BIOLASE, INC BIOL 0001112980 LORD JONATHAN T MD 27042 TOWNE CENTRE DR. SUITE 270 FOOTHILL RANCH CA 92610 1 0 0 0 0 Restricted Stock Unit 2023-06-08 4 A 0 721154 0.00 A Common Stock 721154 779901 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 eleventh month anniversary of the date of grant. /s/ Michael C. Carroll, attorney-in-fact for Jonathan T. Lord 2023-06-12