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  5. CHARLES P. LAWLESS, M.D., P.A.

CHARLES P. LAWLESS, M.D., P.A.

Company Details

Name: CHARLES P. LAWLESS, M.D., P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 11 Aug 1977 (47 years ago)
Financial Date End: 31 Aug 2021
Date dissolved: 17 Nov 2021
Entity Number: 180274
Place of Formation: IDAHO
File Number: 180274
ZIP code: 83201
County: Bannock County
Mailing Address: STE 310 1777 E CLARK ST POCATELLO, ID 83201-3357

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CHARLES P. LAWLESS, M.D., P.A. PROFIT SHARING PLAN 2019 820334175 2021-02-11 CHARLES P. LAWLESS, M.D., P.A. 1
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-05-01
Business code 621111
Sponsor’s telephone number 2082324133
Plan sponsor’s address 1777 E. CLARK, SUITE 310, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2021-02-11
Name of individual signing CHARLES P LAWLESS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-02-11
Name of individual signing CHARLES P LAWLESS
Valid signature Filed with authorized/valid electronic signature
CHARLES P. LAWLESS, M.D., P.A. PROFIT SHARING PLAN 2018 820334175 2020-02-20 CHARLES P. LAWLESS, M.D., P.A. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-05-01
Business code 621111
Sponsor’s telephone number 2082324133
Plan sponsor’s address 1777 E. CLARK, SUITE 310, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2020-02-20
Name of individual signing CHARLES P LAWLESS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-02-20
Name of individual signing CHARLES P LAWLESS
Valid signature Filed with authorized/valid electronic signature
CHARLES P. LAWLESS, M.D., P.A. PROFIT SHARING PLAN 2017 820334175 2019-02-27 CHARLES P. LAWLESS, M.D., P.A. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-05-01
Business code 621111
Sponsor’s telephone number 2082324133
Plan sponsor’s address 1777 E. CLARK, SUITE 310, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2019-02-27
Name of individual signing CHARLES P LAWLESS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-02-27
Name of individual signing CHARLES P LAWLESS
Valid signature Filed with authorized/valid electronic signature
CHARLES P. LAWLESS, M.D., P.A. PROFIT SHARING PLAN 2016 820334175 2018-05-15 CHARLES P. LAWLESS, M.D., P.A. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-05-01
Business code 621111
Sponsor’s telephone number 2082324133
Plan sponsor’s address 1777 E. CLARK, SUITE 310, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2018-05-15
Name of individual signing CHARLES P LAWLESS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-05-15
Name of individual signing CHARLES P LAWLESS
Valid signature Filed with authorized/valid electronic signature
CHARLES P. LAWLESS, M.D., P.A. PROFIT SHARING PLAN 2015 820334175 2017-05-10 CHARLES P. LAWLESS, M.D., P.A. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-05-01
Business code 621111
Sponsor’s telephone number 2082324133
Plan sponsor’s address 1777 E. CLARK, SUITE 310, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2017-05-10
Name of individual signing CHARLES LAWLESS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-10
Name of individual signing CHARLES LAWLESS
Valid signature Filed with authorized/valid electronic signature
CHARLES P. LAWLESS, M.D., P.A. PROFIT SHARING PLAN 2014 820334175 2016-05-13 CHARLES P. LAWLESS, M.D., P.A. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-05-01
Business code 621111
Sponsor’s telephone number 2082324133
Plan sponsor’s address 1777 E. CLARK, SUITE 310, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2016-05-13
Name of individual signing CHARLES P LAWLESS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-05-13
Name of individual signing CHARLES P LAWLESS
Valid signature Filed with authorized/valid electronic signature
CHARLES P. LAWLESS, M.D., P.A. PROFIT SHARING PLAN 2013 820334175 2015-02-16 CHARLES P. LAWLESS, M.D., P.A. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-05-01
Business code 621111
Sponsor’s telephone number 2082324133
Plan sponsor’s address 1777 E. CLARK, SUITE 310, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2015-02-16
Name of individual signing CHARLES LAWLESS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-02-16
Name of individual signing CHARLES LAWLESS
Valid signature Filed with authorized/valid electronic signature
CHARLES P. LAWLESS, M.D., P.A. PROFIT SHARING PLAN 2012 820334175 2014-05-12 CHARLES P. LAWLESS, M.D., P.A. 1
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-05-01
Business code 621111
Sponsor’s telephone number 2082324133
Plan sponsor’s address 1777 E. CLARK, SUITE 310, POCATELLO, ID, 83201

Signature of
Role Plan administrator
Date 2014-05-12
Name of individual signing CHARLES LAWLESS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-05-12
Name of individual signing CHARLES LAWLESS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CHARLES P. LAWLESS M.D. Agent 1777 EAST CLARK STREET, STE 310, POCATELLO, ID 83201

President

Name Role Address Appointed On
CHARLES P LAWLESS President 1667 RUBY, POCATELLO, ID 83201 2020-08-05

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0004499828 2021-11-17
Annual Report 0003960672 2020-08-05
Annual Report 0003585415 2019-08-01
Annual Report 0001635544 2018-06-28
Annual Report 0001635543 2017-06-28
Annual Report 0001635542 2016-06-23
Annual Report 0001635541 2015-06-26
Annual Report 0001635540 2014-06-18
Annual Report 0001635539 2013-06-14
Annual Report 0001635568 2012-07-19

Related by officers

No related officers

Related by address

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Date of last update: 03 Dec 2024

Sources: Idaho Secretary of State

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