0001657369-16-000003.txt : 20161004 0001657369-16-000003.hdr.sgml : 20161004 20161003185007 ACCESSION NUMBER: 0001657369-16-000003 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20161004 DATE AS OF CHANGE: 20161003 EFFECTIVENESS DATE: 20161004 FILER: COMPANY DATA: COMPANY CONFORMED NAME: MD Revolution, Inc. CENTRAL INDEX KEY: 0001657369 IRS NUMBER: 452485559 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-271746 FILM NUMBER: 161916902 BUSINESS ADDRESS: STREET 1: 9191 TOWNE CENTRE DR. SUITE 510 CITY: SAN DIEGO STATE: CA ZIP: 92122 BUSINESS PHONE: 858-847-5064 MAIL ADDRESS: STREET 1: 9191 TOWNE CENTRE DR. SUITE 510 CITY: SAN DIEGO STATE: CA ZIP: 92122 D 1 primary_doc.xml X0707 D LIVE 0001657369 MD Revolution, Inc. 9191 TOWNE CENTRE DR. SUITE 510 SAN DIEGO CA CALIFORNIA 92122 858-847-5064 DELAWARE MDRevoltuion, Inc. La Jolla Institute of Personalized Medicine LLC MDRevolution LLC None Corporation true 2011 Arthur Roke c/o MD Revolution, Inc. 9191 Towne Centre Dr. Suite 510 San Diego CA CALIFORNIA 92122 Executive Officer Samir Damani c/o MD Revolution, Inc. 9191 Towne Centre Dr. Suite 510 San Diego CA CALIFORNIA 92122 Executive Officer Director Gordon Clark c/o MD Revolution, Inc. 9191 Towne Centre Dr. Suite 510 San Diego CA CALIFORNIA 92122 Director Jacqueline Kosecoff c/o MD Revolution, Inc. 9191 Towne Centre Dr. Suite 510 San Diego CA CALIFORNIA 92122 Director Jean Balgrosky c/o MD Revolution, Inc. 9191 Towne Centre Dr. Suite 510 San Diego CA CALIFORNIA 92122 Executive Officer Director Garrett Vygantas c/o MD Revolution, Inc. 9191 Towne Centre Dr. Suite 510 San Diego CA CALIFORNIA 92122 Director Pratik Patel c/o MD Revolution, Inc. 9191 Towne Centre Dr. Suite 510 San Diego CA CALIFORNIA 92122 Executive Officer Other Decline to Disclose 06b false 2016-09-19 false true false 0 32387066 9737189 22649877 $1,944,643.45 cancellation of indebtedness; $7,792,544.69 new cash false 71 0 0 0 false MD Revolution, Inc. /s/ Arthur Roke Arthur Roke Chief Financial Officer 2016-10-03