| Entity Name: | DERMATOLOGY ASSOCIATES OF WATERBURY, P.C. |
| Jurisdiction: | Connecticut |
| Legal type: | Stock |
| Citizenship: | Domestic |
| Status: | Dissolved |
| Date Formed: | 18 Jul 1972 |
| Date of dissolution: | 14 Dec 2011 |
| Business ALEI: | 0013349 |
| Annual report due: | 28 Jul 2011 |
| Business address: | 171 GRANDVIEW AVE, WATERBURY, CT, 06708 |
| ZIP code: | 06708 |
| County: | New Haven |
| Place of Formation: | CONNECTICUT |
| Total authorized shares: | 0 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DERMATOLOGY ASSOCIATES OF WATERBURY, P.C. PROFIT SHARING PLAN | 2010 | 060885625 | 2011-07-14 | DERMATOLOGY ASSOCIATES OF WATERBURY, P.C. | 14 | |||||||||||||||||||||||||||||||
|
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| Administrator’s EIN | 060885625 |
| Plan administrator’s name | DERMATOLOGY ASSOCIATES OF WATERBURY, P.C. |
| Plan administrator’s address | 15 STONEY BROOKS ROAD, MIDDLEBURY, CT, 06762 |
| Administrator’s telephone number | 2037581505 |
Signature of
| Role | Plan administrator |
| Date | 2011-07-14 |
| Name of individual signing | DR. SALVATORE ROMANO |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1973-06-22 |
| Business code | 621399 |
| Sponsor’s telephone number | 2037581505 |
| Plan sponsor’s address | 15 STONEY BROOKS ROAD, MIDDLEBURY, CT, 06762 |
Plan administrator’s name and address
| Administrator’s EIN | 060885625 |
| Plan administrator’s name | DERMATOLOGY ASSOCIATES OF WATERBURY, P.C. |
| Plan administrator’s address | 15 STONEY BROOKS ROAD, MIDDLEBURY, CT, 06762 |
| Administrator’s telephone number | 2037581505 |
Signature of
| Role | Plan administrator |
| Date | 2011-07-14 |
| Name of individual signing | DR. SALVATORE ROMANO |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1973-06-22 |
| Business code | 621399 |
| Sponsor’s telephone number | 2037578919 |
| Plan sponsor’s address | 171 GRANDVIEW AVE., SUITE 103, WATERBURY, CT, 067082517 |
Plan administrator’s name and address
| Administrator’s EIN | 060885625 |
| Plan administrator’s name | DERMATOLOGY ASSOCIATES OF WATERBURY, P.C. |
| Plan administrator’s address | 171 GRANDVIEW AVE., SUITE 103, WATERBURY, CT, 067082517 |
| Administrator’s telephone number | 2037578919 |
Signature of
| Role | Plan administrator |
| Date | 2010-07-08 |
| Name of individual signing | DR. SALVATORE ROMANO |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| DUANE R ANDERSON | Agent | 714 CHASE PKWY, WATERBURY, CT, 06708, United States | OLD LITCHFIELD RD, WASHINGTON, CT, 06793, United States |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| EUGENE MIRRER MD | Officer | 171 GRANDVIEW AVE, WATERBURY, CT, 06708, United States | 16 STONYBROOK RD, MIDDLEBURY, CT, 06762, United States |
| LANCE R. ERIKSEN MD | Officer | 171 GRANDVIEW AVE, WATERBURY, CT, 06708, United States | 216 MAIN ST NORTH, WOODBURY, CT, 06798, United States |
| SALVATORE V. ROMANO JR. MD | Officer | 171 GRANDVIEW AVE, WATERBURY, CT, 06708, United States | 168 NORTH FARM RD, MIDDLEBURY, CT, 06762, United States |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| 0004485802 | 2011-12-14 | 2011-12-14 | Dissolution | Certificate of Dissolution | No data |
| 0004259972 | 2010-08-23 | No data | Annual Report | Annual Report | 2010 |
| 0004029001 | 2009-09-17 | No data | Annual Report | Annual Report | 2009 |
| 0003762524 | 2008-08-20 | No data | Annual Report | Annual Report | 2008 |
| 0003508374 | 2007-07-24 | No data | Annual Report | Annual Report | 2007 |
| 0003284220 | 2006-08-21 | No data | Annual Report | Annual Report | 2006 |
| 0003082150 | 2005-08-03 | No data | Annual Report | Annual Report | 2005 |
| 0002892702 | 2004-08-23 | No data | Annual Report | Annual Report | 2004 |
| 0002779213 | 2004-02-20 | 2004-02-20 | Annual Report | Annual Report | 2003 |
| 0002480279 | 2002-08-01 | 2002-08-01 | Annual Report | Annual Report | 2002 |
Date of last update: 06 Jan 2025
Sources: Connecticut's Official State Website
