0001437749-17-021298.txt : 20171229 0001437749-17-021298.hdr.sgml : 20171229 20171229131042 ACCESSION NUMBER: 0001437749-17-021298 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20171229 DATE AS OF CHANGE: 20171229 EFFECTIVENESS DATE: 20171229 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Provisio Medical, Inc. CENTRAL INDEX KEY: 0001685703 IRS NUMBER: 200305318 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-301989 FILM NUMBER: 171281011 BUSINESS ADDRESS: STREET 1: 10449 HUNTERS RIDGE PLACE CITY: SAN DIEGO STATE: CA ZIP: 92127 BUSINESS PHONE: 5087409940 MAIL ADDRESS: STREET 1: 10449 HUNTERS RIDGE PLACE CITY: SAN DIEGO STATE: CA ZIP: 92127 D 1 primary_doc.xml X0708 D LIVE 0001685703 Provisio Medical, Inc. 16855 West Bernardo Drive Suite 370 SAN DIEGO CA CALIFORNIA 92127 858-304-1670 DELAWARE None None Corporation true 2014 Stephen Eric Ryan c/o Provisio, 16855 West Bernardo Drive Suite 370 San Diego CA CALIFORNIA 92127 Executive Officer Director Promoter Other Technology Decline to Disclose 06b false 2017-12-19 false true Preferred Stock, Series B false 20001 5001000 4095030 905970 false 27 0 0 450000 true Salary plus patent assignment bonus false Provisio Medical, Inc. /s/ Stephen Eric Ryan Stephen Eric Ryan President 2017-12-29