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  5. IlluminOss Medical, Inc.

IlluminOss Medical, Inc.

Company Details

Name: IlluminOss Medical, Inc.
Jurisdiction: Rhode Island
Entity type: Foreign Corporation
Status: Activ
Date of Organization in Rhode Island: 09 Feb 2007 (18 years ago)
Identification Number: 000161600
ZIP code: 02914
County: Providence County
Place of Formation: DELAWARE
Principal Address: 993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914, USA
Purpose: DESIGN DEVELOPMENT AND MANUFACTURING OF MINIMALLY INVASIVE ORTHOPAEDIC MEDICAL DEVICES

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ILLUMINOSS MEDICAL INC. 401(K) PLAN 2023 208179013 2024-06-18 ILLUMINOSS MEDICAL INC. 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 339110
Sponsor’s telephone number 9499814595
Plan sponsor’s address 993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914

Signature of
Role Plan administrator
Date 2024-06-18
Name of individual signing WILLIAM JOHNSON
Valid signature Filed with authorized/valid electronic signature
ILLUMINOSS MEDICAL INC. 401(K) PLAN 2022 208179013 2023-07-18 ILLUMINOSS MEDICAL INC. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 339110
Sponsor’s telephone number 9499814595
Plan sponsor’s address 993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914

Signature of
Role Plan administrator
Date 2023-07-18
Name of individual signing WILLIAM JOHNSON
Valid signature Filed with authorized/valid electronic signature
ILLUMINOSS MEDICAL INC. 401(K) PLAN 2021 208179013 2022-05-18 ILLUMINOSS MEDICAL INC. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 339110
Sponsor’s telephone number 9499814595
Plan sponsor’s address 993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914

Signature of
Role Plan administrator
Date 2022-05-18
Name of individual signing WILLIAM JOHNSON
Valid signature Filed with authorized/valid electronic signature
ILLUMINOSS MEDICAL INC. 401(K) PLAN 2020 208179013 2021-06-11 ILLUMINOSS MEDICAL INC. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 339110
Sponsor’s telephone number 9499814595
Plan sponsor’s address 993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914

Signature of
Role Plan administrator
Date 2021-06-11
Name of individual signing WILLIAM JOHNSON
Valid signature Filed with authorized/valid electronic signature
ILLUMINOSS MEDICAL INC. 401(K) PLAN 2019 208179013 2020-07-07 ILLUMINOSS MEDICAL INC. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 339110
Sponsor’s telephone number 9499814595
Plan sponsor’s address 993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914

Signature of
Role Plan administrator
Date 2020-07-07
Name of individual signing WILLIAM JOHNSON
Valid signature Filed with authorized/valid electronic signature
ILLUMINOSS MEDICAL INC. 401(K) PLAN 2018 208179013 2019-07-29 ILLUMINOSS MEDICAL INC. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 339110
Sponsor’s telephone number 9085073289
Plan sponsor’s address 993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914

Signature of
Role Plan administrator
Date 2019-07-29
Name of individual signing TERRI EVANS
Valid signature Filed with authorized/valid electronic signature
ILLUMINOSS MEDICAL INC. 401(K) PLAN 2017 208179013 2018-09-17 ILLUMINOSS MEDICAL INC. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 339110
Sponsor’s telephone number 4014877954
Plan sponsor’s address 993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914

Signature of
Role Plan administrator
Date 2018-09-17
Name of individual signing TERRI EVANS
Valid signature Filed with authorized/valid electronic signature
ILLUMINOSS MEDICAL INC. 401(K) PLAN 2016 208179013 2017-05-25 ILLUMINOSS MEDICAL INC. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 339110
Sponsor’s telephone number 4017140008
Plan sponsor’s address 993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914

Signature of
Role Plan administrator
Date 2017-05-25
Name of individual signing LUCY DOHERTY
Valid signature Filed with authorized/valid electronic signature
ILLUMINOSS MEDICAL INC. 401(K) PLAN 2015 208179013 2016-07-20 ILLUMINOSS MEDICAL INC. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 339110
Sponsor’s telephone number 4017140008
Plan sponsor’s address 993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914

Signature of
Role Plan administrator
Date 2016-07-20
Name of individual signing LUCY DOHERTY
Valid signature Filed with authorized/valid electronic signature
ILLUMINOSS MEDICAL INC. 401(K) PLAN 2014 208179013 2015-07-01 ILLUMINOSS MEDICAL INC. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 339110
Sponsor’s telephone number 4017140008
Plan sponsor’s address 993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914

Signature of
Role Plan administrator
Date 2015-07-01
Name of individual signing MARTIN ASCHENBRENER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/06/04/20140604154355P040377761075001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 339110
Sponsor’s telephone number 4017140008
Plan sponsor’s address 993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914

Signature of
Role Plan administrator
Date 2014-06-04
Name of individual signing MARTIN ASCHENBRENER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/06/28/20130628072532P030099026261001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 339110
Sponsor’s telephone number 4017140008
Plan sponsor’s address 993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address
Administrator’s EIN 208179013
Plan administrator’s name ILLUMINOSS MEDICAL, INC.
Plan administrator’s address 993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4017140008

Signature of
Role Plan administrator
Date 2013-06-28
Name of individual signing ROBERT RABINER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/10/20121010104804P030000484389001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 339110
Sponsor’s telephone number 4017140008
Plan sponsor’s address 993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address
Administrator’s EIN 208179013
Plan administrator’s name ILLUMINOSS MEDICAL, INC.
Plan administrator’s address 993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4017140008

Signature of
Role Plan administrator
Date 2012-10-10
Name of individual signing ROBERT RABINER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/10/04/20111004112620P040145706065001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 339110
Sponsor’s telephone number 4017140008
Plan sponsor’s address 993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address
Administrator’s EIN 208179013
Plan administrator’s name ILLUMINOSS MEDICAL, INC.
Plan administrator’s address 993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4017140008

Signature of
Role Plan administrator
Date 2011-10-04
Name of individual signing ROBERT RABINER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/14/20101014041418P070012178242001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 339110
Sponsor’s telephone number 4017140008
Plan sponsor’s address 993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address
Administrator’s EIN 208179013
Plan administrator’s name ILLUMINOSS MEDICAL, INC.
Plan administrator’s address 993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4017140008

Signature of
Role Plan administrator
Date 2010-10-13
Name of individual signing ROBERT RABINER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
COGENCY GLOBAL INC. Agent 222 JEFFERSON BOULEVARD, WARWICK, RI, 02888, USA

TREASURER

Name Role Address
WILLIAM S. JOHNSON TREASURER 993 WATERMAN AVENUE EAST PROVIDENCE, RI 02914 USA

SECRETARY

Name Role Address
MILEN TODOROV SECRETARY 993 WATERMAN AVENUE EAST PROVIDENCE, RI 02914 USA

CEO

Name Role Address
MICHAEL P. MOGUL CEO 993 WATERMAN AVENUE EAST PROVIDENCE, RI 02914 USA

CFO

Name Role Address
WILLIAM S. JOHNSON CFO 993 WATERMAN AVENUE EAST PROVIDENCE, RI 02914 USA

VICE PRESIDENT

Name Role Address
MILEN TODOROV VICE PRESIDENT 993 WATERMAN AVENUE EAST PROVIDENCE, RI 02914 USA
ROBERT RABINER VICE PRESIDENT 993 WATERMAN AVENUE EAST PROVIDENCE, RI 02914 USA

DIRECTOR

Name Role Address
JOHN H FOSTER DIRECTOR 993 WATERMAN AVENUE E. PROVIDENCE, RI 02914 USA
DAVID HELFET DIRECTOR 993 WATERMAN AVENUE E. PROVIDENCE, RI 02914 USA

Filings

Number Name File Date
202446822220 Annual Report 2024-02-19
202328835360 Annual Report 2023-02-20
202211307930 Annual Report 2022-02-21
202186771060 Annual Report 2021-01-17
202074584990 Statement of Change of Registered/Resident Agent 2020-11-13
202039455710 Annual Report 2020-05-08
202039449340 Annual Report 2020-05-08
201987945410 Annual Report 2019-03-01
201859527010 Annual Report 2018-03-01
201734783490 Annual Report 2017-02-27

Awards

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
PURCHASE ORDER AWARD W81K0024P0194 2024-08-26 2024-08-26 2024-08-26
Unique Award Key CONT_AWD_W81K0024P0194_9700_-NONE-_-NONE-
Awarding Agency Department of Defense
Link View Page

Award Amounts
Obligated Amount 26136.12
Current Award Amount 26136.12
Potential Award Amount 26136.12

Description
Title UC 0203 FY24 PHOTODYNAMIC CURING SYSTEM
NAICS Code 339112: SURGICAL AND MEDICAL INSTRUMENT MANUFACTURING
Product and Service Codes 6515: MEDICAL AND SURGICAL INSTRUMENTS, EQUIPMENT, AND SUPPLIES

Recipient Details
Recipient ILLUMINOSS MEDICAL, INC.
UEI FR6ZJAWKBL68
Recipient Address UNITED STATES, 993 WATERMAN AVE, EAST PROVIDENCE, PROVIDENCE, RHODE ISLAND, 029141314

Related by officers

COGENCY GLOBAL INC.

Pusterla US, Inc. Arrowstreet, Inc. GARBER'S TRAVEL SERVICE, INC. Brook Village Corporation Chapman Waterproofing Company Nielsen Audio, Inc. Mitsubishi International Corporation SOUTHWESTERN INDUSTRIES, INC. NAACP Empowerment Programs, Inc. UNITED OIL PAINTINGS, INC.

WILLIAM S. JOHNSON

Shirley Ann Properties, LLC ABL Medical Inc.

MILEN TODOROV

ABL Medical Inc.

MICHAEL P. MOGUL

ABL Medical Inc.

ROBERT RABINER

ABL Medical Inc.

DAVID HELFET

ABL Medical Inc.

Related by address

993 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914, USA

ABL Medical Inc.

Date of last update: 10 Oct 2024

Sources: Rhode Island Department of State

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