0001393857-12-000003.txt : 20121005 0001393857-12-000003.hdr.sgml : 20121005 20121005145403 ACCESSION NUMBER: 0001393857-12-000003 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 506 FILED AS OF DATE: 20121005 DATE AS OF CHANGE: 20121005 EFFECTIVENESS DATE: 20121005 FILER: COMPANY DATA: COMPANY CONFORMED NAME: IlluminOss Medical Inc CENTRAL INDEX KEY: 0001393857 IRS NUMBER: 208179013 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-185109 FILM NUMBER: 121132087 BUSINESS ADDRESS: STREET 1: 993 WATERMAN AVENUE CITY: EAST PROVIDENCE STATE: RI ZIP: 02914 BUSINESS PHONE: 4017140008 MAIL ADDRESS: STREET 1: 993 WATERMAN AVENUE CITY: EAST PROVIDENCE STATE: RI ZIP: 02914 D 1 primary_doc.xml X0706 D LIVE 0001393857 IlluminOss Medical Inc 993 WATERMAN AVENUE EAST PROVIDENCE RI RHODE ISLAND 02914 4017140008 DELAWARE None None Corporation true R. Scott Rader 993 Waterman Avenue c/o IlluminOss Medical, Inc. East Providence RI RHODE ISLAND 02914 Executive Officer Director Robert A. Rabiner 993 Waterman Avenue c/o IlluminOss Medical, Inc. East Providence RI RHODE ISLAND 02914 Director Harry T. Rein 993 Waterman Avenue c/o IlluminOss Medical, Inc. East Providence RI RHODE ISLAND 02914 Director Lee R. Wrubel 993 Waterman Avenue c/o IlluminOss Medical, Inc. East Providence RI RHODE ISLAND 02914 Director John Pafford 993 Waterman Avenue c/o IlluminOss Medical, Inc. East Providence RI RHODE ISLAND 02914 Director Ron Hunt 993 Waterman Avenue c/o IlluminOss Medical, Inc. East Providence RI RHODE ISLAND 02914 Director Fouad Azzam 993 Waterman Avenue c/o IlluminOss Medical, Inc. East Providence RI RHODE ISLAND 02914 Director Daniel Omstead 993 Waterman Avenue c/o IlluminOss Medical, Inc. East Providence RI RHODE ISLAND 02914 Director Enrico Petrillo 993 Waterman Avenue c/o IlluminOss Medical, Inc. East Providence RI RHODE ISLAND 02914 Director Rajeev Dadoo 993 Waterman Avenue c/o IlluminOss Medical, Inc. East Providence RI RHODE ISLAND 02914 Director Other Decline to Disclose 06 false 2012-09-26 true true false 21933 38000000 19000000 19000000 false 13 0 0 0 false IlluminOss Medical Inc /s/ R. Scott Rader R. Scott Rader CEO and President 2012-10-05