|
JUSTICE DENTAL RETIREMENT PLAN
|
2021
|
364577879
|
2023-02-10
|
JUSTICE DENTAL BLAZER, PLLC
|
27
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2000-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
8595430700
|
| Plan sponsor’s
address |
3285 BLAZER PARKWAY, SUITE 200, LEXINGTON, KY, 40509
|
Signature of
| Role |
Plan administrator |
| Date |
2023-02-10 |
| Name of individual signing |
LAURA L. JUSTICE DMD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JUSTICE DENTAL RETIREMENT PLAN
|
2020
|
364577879
|
2021-10-14
|
JUSTICE DENTAL BLAZER, PLLC
|
39
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2000-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
8595430700
|
| Plan sponsor’s
address |
3285 BLAZER PARKWAY, SUITE 200, LEXINGTON, KY, 40509
|
Signature of
| Role |
Plan administrator |
| Date |
2021-10-14 |
| Name of individual signing |
LAURA L. JUSTICE DMD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JUSTICE DENTAL RETIREMENT PLAN
|
2019
|
821231623
|
2020-10-13
|
JUSTICE DENTAL BLAZER, PLLC
|
34
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2000-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
8595430700
|
| Plan sponsor’s
address |
3285 BLAZER PARKWAY, SUITE 200, LEXINGTON, KY, 40509
|
Signature of
| Role |
Plan administrator |
| Date |
2020-10-13 |
| Name of individual signing |
LAURA L. JUSTICE DMD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JUSTICE DENTAL RETIREMENT PLAN
|
2018
|
364577879
|
2019-10-14
|
JUSTICE DENTAL BLAZER, PLLC
|
33
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2000-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
8595430700
|
| Plan sponsor’s
address |
3285 BLAZER PARKWAY, SUITE 200, LEXINGTON, KY, 40509
|
Signature of
| Role |
Plan administrator |
| Date |
2019-10-14 |
| Name of individual signing |
LAURA L. JUSTICE DMD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
JUSTICE DENTAL RETIREMENT PLAN
|
2017
|
821231623
|
2018-07-16
|
JUSTICE DENTAL BLAZER, PLLC
|
20
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2000-01-01
|
| Business code |
621210
|
| Sponsor’s telephone number |
8595430700
|
| Plan sponsor’s
address |
3285 BLAZER PARKWAY, SUITE 200, LEXINGTON, KY, 40509
|
Signature of
| Role |
Plan administrator |
| Date |
2018-07-16 |
| Name of individual signing |
LAURA L. JUSTICE DMD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
