0001955031-22-000001.txt : 20221208 0001955031-22-000001.hdr.sgml : 20221208 20221208134845 ACCESSION NUMBER: 0001955031-22-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20221208 DATE AS OF CHANGE: 20221208 EFFECTIVENESS DATE: 20221208 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Excision Medical, Inc. CENTRAL INDEX KEY: 0001955031 IRS NUMBER: 854185068 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-466936 FILM NUMBER: 221452118 BUSINESS ADDRESS: STREET 1: 50 THREE TUN ROAD, SUITE 2 CITY: MALVERN STATE: PA ZIP: 19355 BUSINESS PHONE: 610-334-6091 MAIL ADDRESS: STREET 1: 50 THREE TUN ROAD, SUITE 2 CITY: MALVERN STATE: PA ZIP: 19355 D 1 primary_doc.xml X0708 D LIVE 0001955031 Excision Medical, Inc. 50 THREE TUN ROAD, SUITE 2 MALVERN PA PENNSYLVANIA 19355 610-334-6091 DELAWARE None None Corporation true 2020 Greg Walters 50 Three Tun Road, Suite 2 Malvern PA PENNSYLVANIA 19355 Executive Officer Director President and Chief Executive Officer David Wood 50 Three Tun Road, Suite 2 Malvern PA PENNSYLVANIA 19355 Executive Officer Director Chief Medical Officer Gary Roubin 50 Three Tun Road, Suite 2 Malvern PA PENNSYLVANIA 19355 Director Jason Keiser 50 Three Tun Road, Suite 2 Malvern PA PENNSYLVANIA 19355 Executive Officer Director Secretary and Treasurer Other Health Care Decline to Disclose 06b false 2022-02-23 false true false 0 2500000 1914319 585681 false 29 0 0 0 false Excision Medical, Inc. /s/ Greg Walters Greg Walters President and Chief Executive Officer 2022-12-08