0001437749-19-017307.txt : 20190823 0001437749-19-017307.hdr.sgml : 20190823 20190822174201 ACCESSION NUMBER: 0001437749-19-017307 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20190823 DATE AS OF CHANGE: 20190822 EFFECTIVENESS DATE: 20190823 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: 021-347241 FILM NUMBER: 191046760 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. 10815 Rancho Bernardo Road Suite 110 San Diego CA CALIFORNIA 92127 (858) 304-1670 DELAWARE None None Corporation true 2014 Stephen Eric Ryan c/o Provisio Medical, Inc. 10815 Rancho Bernardo Road, Suite 110 San Diego CA CALIFORNIA 92127 Executive Officer Director Promoter Aurelio Fernandez c/o Provisio Medical, Inc. 10815 Rancho Bernardo Road, Suite 110 San Diego CA CALIFORNIA 92127 Director Timothy Lindenfelser c/o Provisio Medical, Inc. 10815 Rancho Bernardo Road, Suite 110 San Diego CA CALIFORNIA 92127 Director Kenneth McDonnell c/o Provisio Medical, Inc. 10815 Rancho Bernardo Road, Suite 110 San Diego CA CALIFORNIA 92127 Director George Quinoy c/o Provisio Medical, Inc. 10815 Rancho Bernardo Road, Suite 110 San Diego CA CALIFORNIA 92127 Director Other Technology Decline to Disclose 06b false 2019-08-19 false true true Preferred Stock false 50000 3000000 2300000 700000 false 16 0 0 350000 true false Provisio Medical, Inc. /s/ Stephen Eric Ryan Stephen Eric Ryan President 2019-08-22