0001493152-19-018862.txt : 20191206
0001493152-19-018862.hdr.sgml : 20191206
20191206172658
ACCESSION NUMBER: 0001493152-19-018862
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191203
FILED AS OF DATE: 20191206
DATE AS OF CHANGE: 20191206
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: DIGIANDOMENICO ANTHONY
CENTRAL INDEX KEY: 0001083544
STATE OF INCORPORATION: CA
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38552
FILM NUMBER: 191273890
MAIL ADDRESS:
STREET 1: 3600 GREEN COURT, SUITE 350
CITY: ANN ARBOR
STATE: MI
ZIP: 48105
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Provention Bio, Inc.
CENTRAL INDEX KEY: 0001695357
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: P.O. BOX 666
CITY: OLDWICK
STATE: NJ
ZIP: 08858
BUSINESS PHONE: 908-428-9136
MAIL ADDRESS:
STREET 1: P.O. BOX 666
CITY: OLDWICK
STATE: NJ
ZIP: 08858
FORMER COMPANY:
FORMER CONFORMED NAME: Provention Inc.
DATE OF NAME CHANGE: 20170120
4
1
ownership.xml
X0306
4
2019-12-03
0
0001695357
Provention Bio, Inc.
PRVB
0001083544
DIGIANDOMENICO ANTHONY
C/O PROVENTION BIO, INC.
P.O. BOX 666
OLDWICK
NJ
08858
1
0
0
0
Common Stock
2019-12-03
4
J
0
342000
0
A
520712
D
Pro rata distribution from MDB Capital Group LLC, of which the reporting person is a minority owner.
/s/ Andrew Drechsler, as attorney-in-fact
2019-12-06