0001235802-17-000118.txt : 20170726 0001235802-17-000118.hdr.sgml : 20170726 20170726164914 ACCESSION NUMBER: 0001235802-17-000118 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170726 DATE AS OF CHANGE: 20170726 EFFECTIVENESS DATE: 20170726 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ENTELLUS MEDICAL INC CENTRAL INDEX KEY: 0001374128 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 204627978 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-291556 FILM NUMBER: 17983481 BUSINESS ADDRESS: STREET 1: 3600 HOLLY LANE NORTH STREET 2: SUITE 40 CITY: PLYMOUTH STATE: MN ZIP: 55447 BUSINESS PHONE: 763-463-1595 MAIL ADDRESS: STREET 1: 3600 HOLLY LANE NORTH STREET 2: SUITE 40 CITY: PLYMOUTH STATE: MN ZIP: 55447 D 1 primary_doc.xml X0708 D LIVE 0001374128 ENTELLUS MEDICAL INC 3600 HOLLY LANE NORTH SUITE 40 PLYMOUTH MN MINNESOTA 55447 763-463-1595 DELAWARE None None Corporation true Robert S. White 3600 Holly Lane North Suite 40 Plymouth MN MINNESOTA 55447 Executive Officer Director John K. Bakewell 3600 Holly Lane North Suite 40 Plymouth MN MINNESOTA 55447 Director Joshua J. Baltzell 3600 Holly Lane North Suite 40 Plymouth MN MINNESOTA 55447 Director Brian E. Farley 3600 Holly Lane North Suite 40 Plymouth MN MINNESOTA 55447 Director Shawn T McCormick 3600 Holly Lane North Suite 40 Plymouth MN MINNESOTA 55447 Director David B. Milne 3600 Holly Lane North Suite 40 Plymouth MN MINNESOTA 55447 Director James C. Momtazee 3600 Holly Lane North Suite 40 Plymouth MN MINNESOTA 55447 Director Guido Neels 3600 Holly Lane North Suite 40 Plymouth MN MINNESOTA 55447 Director Douglas Rohlen 3600 Holly Lane North Suite 40 Plymouth MN MINNESOTA 55447 Director Jonelle R. Burnham 3600 Holly Lane North Suite 40 Plymouth MN MINNESOTA 55447 Executive Officer Martha J. Christian 3600 Holly Lane North Suite 40 Plymouth MN MINNESOTA 55447 Executive Officer Donald A. Gonzales 3600 Holly Lane North Suite 40 Plymouth MN MINNESOTA 55447 Executive Officer Kevin L. Mensink 3600 Holly Lane North Suite 40 Plymouth MN MINNESOTA 55447 Executive Officer Brent A. Moen 3600 Holly Lane North Suite 40 Plymouth MN MINNESOTA 55447 Executive Officer Stephen R. Paidosh 3600 Holly Lane North Suite 40 Plymouth MN MINNESOTA 55447 Executive Officer Karen E. Peterson 3600 Holly Lane North Suite 40 Plymouth MN MINNESOTA 55447 Executive Officer Timothy B. Petrick 3600 Holly Lane North Suite 40 Plymouth MN MINNESOTA 55447 Executive Officer Michael H. Rosenthal 3600 Holly Lane North Suite 40 Plymouth MN MINNESOTA 55447 Executive Officer Thomas P. Williamson 3600 Holly Lane North Suite 40 Plymouth MN MINNESOTA 55447 Executive Officer Other Health Care $25,000,001 - $100,000,000 06b false 2017-07-13 false true true 0 49999380 49999380 0 $14.6615 per share based on average closing price on NASDAQ of a share of common stock on each of the 20 consecutive trading days immediately prior to two consecutive trading days prior to the date of the payment of the contingent merger consideration. false 45 0 0 0 false ENTELLUS MEDICAL INC /s/ Brent A. Moen Brent A. Moen Chief Financial Officer and Secretary 2017-07-26