0001516068-21-000001.txt : 20210503 0001516068-21-000001.hdr.sgml : 20210503 20210503171840 ACCESSION NUMBER: 0001516068-21-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20210503 DATE AS OF CHANGE: 20210503 EFFECTIVENESS DATE: 20210503 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Avisa Pharma Inc. CENTRAL INDEX KEY: 0001516068 IRS NUMBER: 273584660 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-398010 FILM NUMBER: 21884705 BUSINESS ADDRESS: STREET 1: 1660A OLD PECOS TRAIL CITY: SANTA FE STATE: NM ZIP: 87505 BUSINESS PHONE: 505-820-1400 MAIL ADDRESS: STREET 1: 1660A OLD PECOS TRAIL CITY: SANTA FE STATE: NM ZIP: 87505 D 1 primary_doc.xml X0708 D LIVE 0001516068 Avisa Pharma Inc. 1660A OLD PECOS TRAIL SANTA FE NM NEW MEXICO 87505 505-820-1400 DELAWARE None None Corporation true David S. Joseph 1660A Old Pecos Trail Santa Fe NM NEW MEXICO 87505 Executive Officer Director Chuck J. Morrison 1660A Old Pecos Trail Santa Fe NM NEW MEXICO 87505 Director Brian P. Birk 1660A Old Pecos Trail Santa Fe NM NEW MEXICO 87505 Director William A. Miller 1660A Old Pecos Trail Santa Fe NM NEW MEXICO 87505 Director Thomas R. Morse 1660A Old Pecos Trail Santa Fe NM NEW MEXICO 87505 Director Matthew R. Culler 1660A Old Pecos Trail Santa Fe NM NEW MEXICO 87505 Executive Officer Other Health Care Decline to Disclose 06b false 2021-04-16 false true true true false 0 693336 693336 0 false 21 0 0 0 false Avisa Pharma Inc. David S. Joseph David S. Joseph CEO and President 2021-05-03