Business Information
Business Information
| Business Name |
Smiles By Design Group
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| Street Address (Including Unit or Suite, if applicable) |
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| City, State, Zip |
Richmond, IL 60071
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| Business Phone |
+18156784551
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| Business Fax |
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| Email Address |
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| Would you like to sign up for the Village E-Blast for current events and information? |
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| Website Address |
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Business Owner Information
| Business Owner(s) Name |
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|
| Business Owner(s) Home Address |
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| Business Owner(s) Phone Number (Home or Cellphone) |
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Is This A New Business?
| Is This A New Business? |
No, my business was registered under the same name prior to May 1st of this year.
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Other Important Information
| Illinois Sales and Use Tax and/or Retailers Occupation Tax |
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| Operating Days |
Monday, Wednesday, Thursday, Saturday
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| Operating Hours |
Monday 11:00-7:00
Wednesday 9:00-5:00
Thursday 12:00-6:00
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| Number of Shifts |
1
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| Number of Employees |
4
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| Nature of Business |
Dentist
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Fueling Stations
| Does your business have fueling stations on site? |
No
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Hoses
Police Required Information
| Burglar Alarm |
No
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| Fire Alarm |
No
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| Hazardous Materials |
Yes
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Hazardous Materials
| Provide Detail Information |
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Emergency Contacts: Please provide 3 names/phone numbers of key holders who are available 24 hours in case of an emergency.
| 1) Name |
Lisa Salisbury
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| 1) Phone Number |
+17792201295
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| 1) Alternate Phone Number |
+18154440549
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| 2) Name |
James Reichle
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| 2) Phone Number |
+18154440549
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| 2) Alternate Phone Number |
+17792201295
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| 3) Name |
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| 3) Phone Number |
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| 3) Alternate Phone Number |
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Assign Certificate Number
Certification Number
| Certificate No |
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| Fiscal Year |
2026
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