0001386760-15-000003.txt : 20151113 0001386760-15-000003.hdr.sgml : 20151113 20151113153620 ACCESSION NUMBER: 0001386760-15-000003 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20151113 DATE AS OF CHANGE: 20151113 EFFECTIVENESS DATE: 20151113 FILER: COMPANY DATA: COMPANY CONFORMED NAME: QLIANCE MEDICAL MANAGEMENT INC. CENTRAL INDEX KEY: 0001386760 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-251227 FILM NUMBER: 151228947 BUSINESS ADDRESS: STREET 1: 2101 FOURTH AVENUE, SUITE 600 CITY: SEATTLE STATE: WA ZIP: 98121 BUSINESS PHONE: 206-913-4700 MAIL ADDRESS: STREET 1: 2101 FOURTH AVENUE, SUITE 600 CITY: SEATTLE STATE: WA ZIP: 98121 FORMER COMPANY: FORMER CONFORMED NAME: BlissMD Inc DATE OF NAME CHANGE: 20070117 D 1 primary_doc.xml X0707 D LIVE 0001386760 QLIANCE MEDICAL MANAGEMENT INC. 2101 FOURTH AVENUE, SUITE 600 SEATTLE WA WASHINGTON 98121 206-913-4700 DELAWARE BlissMD Inc Corporation true ERIKA BLISS C/O QLIANCE MEDICAL MANAGEMENT INC. 2101 FOURTH AVENUE, SUITE 600 SEATTLE WA WASHINGTON 98121 Executive Officer Director JAN BERGER C/O QLIANCE MEDICAL MANAGEMENT INC. 2101 FOURTH AVENUE, SUITE 600 SEATTLE WA WASHINGTON 98121 Director ROB COPPEDGE C/O QLIANCE MEDICAL MANAGEMENT INC. 2101 FOURTH AVENUE, SUITE 600 SEATTLE WA WASHINGTON 98121 Director CAMERON MURRAY C/O QLIANCE MEDICAL MANAGEMENT INC. 2101 FOURTH AVENUE, SUITE 600 SEATTLE WA WASHINGTON 98121 Director TODD HIXON C/O QLIANCE MEDICAL MANAGEMENT INC. 2101 FOURTH AVENUE, SUITE 600 SEATTLE WA WASHINGTON 98121 Director ABOLFAZL SIRJANI C/O QLIANCE MEDICAL MANAGEMENT INC. 2101 FOURTH AVENUE, SUITE 600 SEATTLE WA WASHINGTON 98121 Executive Officer Other Health Care Decline to Disclose 06b false 2015-11-02 false true true true true false 0 2000000 450000 1550000 false 6 0 0 0 false QLIANCE MEDICAL MANAGEMENT INC. ERIKA BLISS ERIKA BLISS PRESIDENT AND CHIEF EXECUTIVE OFFICER 2015-11-13