0001437749-23-009699.txt : 20230407 0001437749-23-009699.hdr.sgml : 20230407 20230406173537 ACCESSION NUMBER: 0001437749-23-009699 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20230407 DATE AS OF CHANGE: 20230406 EFFECTIVENESS DATE: 20230407 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: 021-478195 FILM NUMBER: 23807284 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) 524-3901 DELAWARE None None Corporation true 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 Frank J. Del Rio c/o Provisio Medical, Inc. 10815 Rancho Bernardo Road, Suite 110 San Diego CA CALIFORNIA 92127 Director Michael Chobotov c/o Provisio Medical, Inc. 10815 Rancho Bernardo Road, Suite 110 San Diego CA CALIFORNIA 92127 Director John McCallum JAM Capital Partners PO Box 20097 St. Simons Island GA GEORGIA 31522 Director John Blake c/o Provisio Medical, Inc. 10815 Racho Bernardo Road, Suite 110 San Diego CA CALIFORNIA 92127 Executive Officer Other Technology Decline to Disclose 06b false 2023-04-03 false true true Preferred Stock false 100000 LifeSci Capital 168404 LifeSci Capital 168404 250 West 55th Street 34th Floor New York NY NEW YORK 10019 All States 25000000 4519532 20480468 false 19 115500 true 0 Broker also to receive warrant compensation = equity warrants equal to 1% of the Gross Proceeds sold by said broker. Term of five years, cashless exercise option, convertible into common shares, and exercise price = 125% of the price per share paid by in 500000 true false Provisio Medical, Inc. /s/ Stephen Eric Ryan Stephen Eric Ryan President 2023-04-05