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  5. Mark T. Wheaton, MD, PLLC

Mark T. Wheaton, MD, PLLC

Company Details

Name: Mark T. Wheaton, MD, PLLC
Jurisdiction: Minnesota
Legal type: Limited Liability Company (Domestic)
Status: Active / In Good Standing
Date formed: 21 Jul 1998 (26 years ago)
Company Number: 3510ee30-aed4-e011-a886-001ec94ffe7f
File Number: 8536-LLC
Registered Office Address: 21920 Minnetonka Blvd, Excelsior, MN 55331, USA
ZIP code: 55331
County: Hennepin County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LAKESIDE SPORTS & PAIN CLINIC RETIREMENT PLAN 2023 411824173 2024-03-13 MARK T. WHEATON, MD, PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621399
Sponsor’s telephone number 9525930500
Plan sponsor’s address 21920 MINNETONKA BLVD., EXCELSIOR, MN, 55331

Signature of
Role Plan administrator
Date 2024-03-13
Name of individual signing MARK WHEATON
Valid signature Filed with authorized/valid electronic signature
LAKESIDE SPORTS & PAIN CLINIC RETIREMENT PLAN 2022 411824173 2023-01-16 MARK T. WHEATON, MD, PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621399
Sponsor’s telephone number 9525930500
Plan sponsor’s address 21920 MINNETONKA BLVD., EXCELSIOR, MN, 55331

Signature of
Role Plan administrator
Date 2023-01-16
Name of individual signing MARK WHEATON
Valid signature Filed with authorized/valid electronic signature
LAKESIDE SPORTS & PAIN CLINIC RETIREMENT PLAN 2021 411824173 2022-07-12 MARK T. WHEATON, MD, PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621399
Sponsor’s telephone number 9525930500
Plan sponsor’s address 21920 MINNETONKA BLVD., EXCELSIOR, MN, 55331

Signature of
Role Plan administrator
Date 2022-07-12
Name of individual signing MARK WHEATON
Valid signature Filed with authorized/valid electronic signature
LAKESIDE SPORTS & PAIN CLINIC RETIREMENT PLAN 2020 411824173 2021-07-14 MARK T. WHEATON, MD, PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621399
Sponsor’s telephone number 9525930500
Plan sponsor’s address 21920 MINNETONKA BLVD., EXCELSIOR, MN, 55331

Signature of
Role Plan administrator
Date 2021-07-14
Name of individual signing MARK WHEATON
Valid signature Filed with authorized/valid electronic signature
LAKESIDE SPORTS & PAIN CLINIC RETIREMENT PLAN 2019 411824173 2020-08-02 MARK T. WHEATON, MD, PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621399
Sponsor’s telephone number 9525930500
Plan sponsor’s address 21920 MINNETONKA BLVD., EXCELSIOR, MN, 55331

Signature of
Role Plan administrator
Date 2020-08-02
Name of individual signing MARK WHEATON
Valid signature Filed with authorized/valid electronic signature
LAKESIDE SPORTS & PAIN CLINIC RETIREMENT PLAN 2018 411824173 2019-01-29 MARK T. WHEATON, MD, PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621399
Sponsor’s telephone number 9525930500
Plan sponsor’s address 21920 MINNETONKA BLVD., EXCELSIOR, MN, 55331

Signature of
Role Plan administrator
Date 2019-01-29
Name of individual signing MARK WHEATON
Valid signature Filed with authorized/valid electronic signature
LAKESIDE SPORTS & PAIN CLINIC RETIREMENT PLAN 2017 411824173 2018-07-18 MARK T. WHEATON, MD, PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621399
Sponsor’s telephone number 9525930500
Plan sponsor’s address 21920 MINNETONKA BLVD., EXCELSIOR, MN, 55331

Signature of
Role Plan administrator
Date 2018-07-18
Name of individual signing MARK WHEATON
Valid signature Filed with authorized/valid electronic signature
LAKESIDE SPORTS & PAIN CLINIC RETIREMENT PLAN 2016 411824173 2017-02-06 MARK T. WHEATON, MD, PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621399
Sponsor’s telephone number 9525930500
Plan sponsor’s address 21920 MINNETONKA BLVD., EXCELSIOR, MN, 55331

Signature of
Role Plan administrator
Date 2017-02-06
Name of individual signing MARK WHEATON
Valid signature Filed with authorized/valid electronic signature
LAKESIDE SPORTS & PAIN CLINIC RETIREMENT PLAN 2015 411824173 2016-04-20 MARK T. WHEATON, MD, PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621399
Sponsor’s telephone number 9525930500
Plan sponsor’s address 21920 MINNETONKA BLVD., EXCELSIOR, MN, 55331

Signature of
Role Plan administrator
Date 2016-04-20
Name of individual signing MARK WHEATON
Valid signature Filed with authorized/valid electronic signature
LAKESIDE SPORTS & PAIN CLINIC RETIREMENT PLAN 2014 411824173 2015-07-13 MARK T. WHEATON, MD, PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621399
Sponsor’s telephone number 9525930500
Plan sponsor’s address 21920 MINNETONKA BLVD., EXCELSIOR, MN, 55331

Signature of
Role Plan administrator
Date 2015-07-13
Name of individual signing MARK WHEATON
Valid signature Filed with authorized/valid electronic signature

Manager

Name Role Address
Mark Wheaton Manager 21920 Minnetonka Blvd, Excelsior, MN 55331–8615, USA

Agent

Name Role
Mark T Wheaton Agent

Filing

Filing Name Filing date
Annual Reinstatement - Limited Liability Company (Domestic) 2019-02-13
Conversion to 322C Due to Statute Mandate – Limited Liability Company (Domestic) 2018-01-01
Administrative Termination Name Hold Release - Limited Liability Company (Domestic) 2014-02-28
Administrative Termination - Limited Liability Company (Domestic) 2013-02-26
Registered Office and/or Agent - Limited Liability Company (Domestic) 2001-08-20
Limited Liability Company (Domestic) Biennial Renewal 2000-04-03
Limited Liability Company (Domestic) Business Name (Business Name: Mark T. Wheaton, MD, PLLC) 1998-09-28
Original Filing - Limited Liability Company (Domestic) 1998-07-21
Limited Liability Company (Domestic) Business Name (Business Name: Mark T. Wheaton, PLLC) 1998-07-21

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21920 Minnetonka Blvd, Excelsior, MN 55331, USA

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Date of last update: 30 Sep 2024

Sources: Minnesota's Official State Website

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