0000897069-13-000374.txt : 20131009 0000897069-13-000374.hdr.sgml : 20131009 20131009122418 ACCESSION NUMBER: 0000897069-13-000374 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20131009 DATE AS OF CHANGE: 20131009 EFFECTIVENESS DATE: 20131009 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Fibroblast, Inc. CENTRAL INDEX KEY: 0001587278 IRS NUMBER: 455385914 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-204265 FILM NUMBER: 131142868 BUSINESS ADDRESS: STREET 1: 2835 N. SHEFFIELD AVENUE STREET 2: SUITE 303 CITY: CHICAGO STATE: IL ZIP: 60657 BUSINESS PHONE: (312) 834-7864 MAIL ADDRESS: STREET 1: 2835 N. SHEFFIELD AVENUE STREET 2: SUITE 303 CITY: CHICAGO STATE: IL ZIP: 60657 D 1 primary_doc.xml X0707 D LIVE 0001587278 Fibroblast, Inc. 2835 N. SHEFFIELD AVENUE SUITE 303 CHICAGO IL ILLINOIS 60657 (312) 834-7864 DELAWARE None None Corporation true 2012 Scott Vold 2835 N. Sheffield Avenue Suite 303 Chicago IL ILLINOIS 60657 Executive Officer Director Promoter Andrew Albert 2835 N. Sheffield Avenue Suite 303 Chicago IL ILLINOIS 60657 Executive Officer Director Christopher Capps c/o Fibroblast, Inc. 2835 N. Sheffield Avenue, Suite 303 Chicago IL ILLINOIS 60657 Director Jordan Dolin c/o Fibroblast, Inc. 2835 n. Sheffield Avenue, Suite 303 Chicago IL ILLINOIS 60657 Director Other Technology $1 - $1,000,000 06b false 2013-09-13 false true false 0 800000 727668 72332 false 11 0 0 60000 true false Fibroblast, Inc. Scott Vold Scott Vold Chief Executive Officer and President 2013-10-09