| Plan Name | LONE STAR STATE DERMATOLOGY CLINIC 401(K) PLAN |
| Plan identification number | 001 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
|
| Company Name: | LONE STAR STATE DERMATOLOGY CLINIC PLLC |
| Employer identification number (EIN): | 474637409 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 001 | 2019-01-01 | JEAN-DENIS BOUCHER | 2019-08-30 | JEAN-DENIS BOUCHER | 2019-08-30 |
| 001 | 2018-01-01 | JEAN-DENIS BOUCHER | 2019-09-04 | JEAN-DENIS BOUCHER | 2019-09-04 |
| 001 | 2017-01-01 | REYES MICHELLE | 2018-09-18 | REYES MICHELLE | 2018-09-18 |
| 001 | 2016-01-01 | MICHELLE REYES | 2017-09-18 | MICHELLE REYES | 2017-09-18 |