0001701622-21-000001.txt : 20211206 0001701622-21-000001.hdr.sgml : 20211206 20211206134013 ACCESSION NUMBER: 0001701622-21-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06c FILED AS OF DATE: 20211206 DATE AS OF CHANGE: 20211206 EFFECTIVENESS DATE: 20211206 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ActivOrtho, Inc. CENTRAL INDEX KEY: 0001701622 IRS NUMBER: 384024005 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-423761 FILM NUMBER: 211472735 BUSINESS ADDRESS: STREET 1: 2485 XENIUM LANE NORTH CITY: PLYMOUTH STATE: MN ZIP: 55441 BUSINESS PHONE: 651-341-3805 MAIL ADDRESS: STREET 1: 2485 XENIUM LANE NORTH CITY: PLYMOUTH STATE: MN ZIP: 55441 D 1 primary_doc.xml X0708 D LIVE 0001701622 ActivOrtho, Inc. 2485 XENIUM LANE NORTH PLYMOUTH MN MINNESOTA 55441 651-341-3805 DELAWARE None None Corporation true 2017 Steven Healy c/o ActivOrtho, Inc. 2485 Xenium Lane North Plymouth MN MINNESOTA 55441 Executive Officer Director Robert A. Kukuljan c/o ActivOrtho, Inc. 2485 Xenium Lane North Plymouth MN MINNESOTA 55441 Executive Officer Michael Brenzel c/o ActivOrtho, Inc. 2485 Xenium Lane North Plymouth MN MINNESOTA 55441 Director Paul Buckman c/o ActivOrtho, Inc. 2485 Xenium Lane North Plymouth MN MINNESOTA 55441 Director John Deedrick c/o ActivOrtho, Inc. 2485 Xenium Lane North Plymouth MN MINNESOTA 55441 Director Paul Hindrichs c/o ActivOrtho, Inc. 2485 Xenium Lane North Plymouth MN MINNESOTA 55441 Director Andrew Palmer c/o ActivOrtho, Inc. 2485 Xenium Lane North Plymouth MN MINNESOTA 55441 Director Other Technology Decline to Disclose 06c false 2021-11-24 false true true false 10000 500000 60000 440000 false 6 0 0 200000 true false ActivOrtho, Inc. Robert A. Kukuljan Robert A. Kukuljan Secretary 2021-12-06