0000897069-18-000026.txt : 20180116 0000897069-18-000026.hdr.sgml : 20180116 20180116115000 ACCESSION NUMBER: 0000897069-18-000026 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20180116 DATE AS OF CHANGE: 20180116 EFFECTIVENESS DATE: 20180116 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: 021-303268 FILM NUMBER: 18527917 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 X0708 D LIVE 0001587278 Fibroblast, Inc. 222 Merchandise Mart Plaza Suite 1230 CHICAGO IL ILLINOIS 60654 (800) 396-6463 DELAWARE None None Corporation true Scott Vold 222 Merchandise Mart Plaza Suite 1230 Chicago IL ILLINOIS 60654 Executive Officer Director Andrew Albert 222 Merchandise Mart Plaza Suite 1230 Chicago IL ILLINOIS 60654 Executive Officer Kevin Weinstein c/o Fibroblast, Inc. 222 Merchandise Mart Plaza, Suite 1230 Chicago IL ILLINOIS 60654 Director Jordan Dolin c/o Fibroblast, Inc. 222 Merchandise Mart Plaza, Suite 1230 Chicago IL ILLINOIS 60654 Director Elias Pearson c/o Fibroblast, Inc. 222 Merchandise Mart Plaza, Suite 1230 Chicago IL ILLINOIS 60654 Director Kirk Elder c/o Fibroblast, Inc. 222 Merchandise Mart Plaza, Suite 1230 Chicago IL ILLINOIS 60654 Director Other Technology Decline to Disclose 06b false 2018-01-03 false true false 0 5000000 2000000 3000000 false 3 0 0 0 false Fibroblast, Inc. Scott Vold Scott Vold Chief Executive Officer and President 2018-01-15