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  5. LAKE CUMBERLAND ENDODONTICS, PSC

LAKE CUMBERLAND ENDODONTICS, PSC

Company Details

Name: LAKE CUMBERLAND ENDODONTICS, PSC
Jurisdiction: Kentucky
Profit or Non-Profit: Profit
Legal type: Kentucky Professional Services Corp
Status: Active
Standing: Good
File Date: 27 May 2003 (22 years ago)
Organization Date: 27 May 2003 (22 years ago)
Last Annual Report: 24 Mar 2024 (10 months ago)
Organization Number: 0560867
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 42503
Primary County: Pulaski
Principal Office: 87 SARAH'S LANE, SOMERSET, KY 42503
Place of Formation: KENTUCKY
Authorized Shares: 1000

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LAKE CUMBERLAND ENDODONTICS, PSC RETIREMENT PLAN 2023 320078470 2024-10-14 LAKE CUMBERLAND ENDODONTICS, PSC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 6066793010
Plan sponsor’s address 87 SARAH'S LANE, SOMERSET, KY, 42503

Signature of
Role Plan administrator
Date 2024-10-14
Name of individual signing SHEA CHEUVRONT
Valid signature Filed with authorized/valid electronic signature
LAKE CUMBERLAND ENDODONTICS, PSC RETIREMENT PLAN 2022 320078470 2023-10-16 LAKE CUMBERLAND ENDODONTICS, PSC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 6066793010
Plan sponsor’s address 87 SARAH'S LANE, SOMERSET, KY, 42503

Signature of
Role Plan administrator
Date 2023-10-16
Name of individual signing SHEA CHEUVRONT
Valid signature Filed with authorized/valid electronic signature
LAKE CUMBERLAND ENDODONTICS, PSC RETIREMENT PLAN 2021 320078470 2022-10-14 LAKE CUMBERLAND ENDODONTICS, PSC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 6066793010
Plan sponsor’s address 87 SARAH'S LANE, SOMERSET, KY, 42503

Signature of
Role Plan administrator
Date 2022-10-14
Name of individual signing SHEA CHEUVRONT
Valid signature Filed with authorized/valid electronic signature
LAKE CUMBERLAND ENDODONTICS, PSC RETIREMENT PLAN 2020 320078470 2021-09-15 LAKE CUMBERLAND ENDODONTICS, PSC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 6066793010
Plan sponsor’s address 87 SARAH'S LANE, SOMERSET, KY, 42503

Signature of
Role Plan administrator
Date 2021-09-15
Name of individual signing SHEA CHEUVRONT
Valid signature Filed with authorized/valid electronic signature
LAKE CUMBERLAND ENDODONTICS, PSC RETIREMENT PLAN 2019 320078470 2020-06-30 LAKE CUMBERLAND ENDODONTICS, PSC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 6066793010
Plan sponsor’s address 87 SARAH'S LANE, SOMERSET, KY, 42503

Signature of
Role Plan administrator
Date 2020-06-30
Name of individual signing SHEA CHEUVRONT
Valid signature Filed with authorized/valid electronic signature
LAKE CUMBERLAND ENDODONTICS, PSC RETIREMENT PLAN 2018 320078470 2019-07-11 LAKE CUMBERLAND ENDODONTICS, PSC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 6066793010
Plan sponsor’s address 87 SARAH'S LANE, SOMERSET, KY, 42503

Signature of
Role Plan administrator
Date 2019-07-11
Name of individual signing SHEA CHEUVRONT
Valid signature Filed with authorized/valid electronic signature
LAKE CUMBERLAND ENDODONTICS, PSC RETIREMENT PLAN 2017 320078470 2018-09-24 LAKE CUMBERLAND ENDODONTICS, PSC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 6066793010
Plan sponsor’s address 87 SARAH'S LANE, SOMERSET, KY, 42503

Signature of
Role Plan administrator
Date 2018-09-24
Name of individual signing SHEA CHEUVRONT
Valid signature Filed with authorized/valid electronic signature
LAKE CUMBERLAND ENDODONTICS, PSC RETIREMENT PLAN 2016 320078470 2017-07-25 LAKE CUMBERLAND ENDODONTICS, PSC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 6066793010
Plan sponsor’s address 83 SARAH'S LANE, SOMERSET, KY, 42503

Signature of
Role Plan administrator
Date 2017-07-25
Name of individual signing SHEA CHEUVRONT
Valid signature Filed with authorized/valid electronic signature
LAKE CUMBERLAND ENDODONTICS, PSC RETIREMENT PLAN 2015 320078470 2016-08-31 LAKE CUMBERLAND ENDODONTICS, PSC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 6066793010
Plan sponsor’s address 83 SARAH'S LANE, SOMERSET, KY, 42503

Signature of
Role Plan administrator
Date 2016-08-31
Name of individual signing BARRY BURKETT
Valid signature Filed with authorized/valid electronic signature
LAKE CUMBERLAND ENDODONTICS, PSC RETIREMENT PLAN 2014 320078470 2015-07-08 LAKE CUMBERLAND ENDODONTICS, PSC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 6066793010
Plan sponsor’s address 83 SARAH'S LANE, SOMERSET, KY, 42503

Plan administrator’s name and address
Administrator’s EIN 320078470
Plan administrator’s name LAKE CUMBERLAND ENDODONTICS, PSC
Plan administrator’s address 83 SARAHS LANE, SOMERSET, KY, 42503
Administrator’s telephone number 6066793010

Signature of
Role Plan administrator
Date 2015-07-08
Name of individual signing BARRY BURKETT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/09/08/20140908082848P030046769453001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 6066793010
Plan sponsor’s address 83 SARAH'S LANE, SOMERSET, KY, 42503

Plan administrator’s name and address
Administrator’s EIN 320078470
Plan administrator’s name LAKE CUMBERLAND ENDODONTICS, PSC
Plan administrator’s address 83 SARAHS LANE, SOMERSET, KY, 42503
Administrator’s telephone number 6066793010

Signature of
Role Plan administrator
Date 2014-09-08
Name of individual signing BARRY BURKETT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/23/20130723074445P040401972753001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 6066793010
Plan sponsor’s address 83 SARAH'S LANE, SOMERSET, KY, 42503

Plan administrator’s name and address
Administrator’s EIN 320078470
Plan administrator’s name LAKE CUMBERLAND ENDODONTICS, PSC
Plan administrator’s address 83 SARAHS LANE, SOMERSET, KY, 42503
Administrator’s telephone number 6066793010

Signature of
Role Plan administrator
Date 2013-07-23
Name of individual signing BARRY BURKETT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/09/20120709121446P040056053442001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 6066793010
Plan sponsor’s address 83 SARAHS LANE, SOMERSET, KY, 42503

Plan administrator’s name and address
Administrator’s EIN 320078470
Plan administrator’s name LAKE CUMBERLAND ENDODONTICS, PSC
Plan administrator’s address 83 SARAHS LANE, SOMERSET, KY, 42503
Administrator’s telephone number 6066793010

Signature of
Role Plan administrator
Date 2012-07-09
Name of individual signing BARRY L. BURKETT, MD
Valid signature Filed with authorized/valid electronic signature

Shareholder

Name Role
Christopher SHEA CHEUVRONT Shareholder

Incorporator

Name Role
BARRY L. BURKETT Incorporator

Registered Agent

Name Role
C. SHEA CHEUVRONT Registered Agent

President

Name Role
Christopher Shea Cheuvront President

Secretary

Name Role
Ashley Thompson Cheuvront Secretary

Filings

Name File Date
Annual Report 2024-03-24
Annual Report 2023-08-09
Annual Report 2022-08-05
Annual Report 2021-06-25
Annual Report 2020-08-20
Annual Report 2019-05-08
Annual Report 2018-03-28
Annual Report 2017-03-21
Registered Agent name/address change 2016-12-08
Annual Report 2016-03-22

Related by officers

Ashley Thompson Cheuvront

Thompson Drug Nancy Inc THOMPSON DRUG SOMERSET INC

Related by address

No related companies by address

Date of last update: 30 Dec 2024

Sources: Kentucky Secretary of State

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