0001415889-21-004721.txt : 20211004 0001415889-21-004721.hdr.sgml : 20211004 20211004181339 ACCESSION NUMBER: 0001415889-21-004721 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210923 FILED AS OF DATE: 20211004 DATE AS OF CHANGE: 20211004 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Korenko Michael K CENTRAL INDEX KEY: 0001486806 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-53497 FILM NUMBER: 211304392 MAIL ADDRESS: STREET 1: 6208 W OKANOGAN AVE CITY: KENNEWICK STATE: WA ZIP: 99336 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: VIVOS INC CENTRAL INDEX KEY: 0001449349 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 800138937 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 719 JADWIN AVENUE CITY: RICHLAND STATE: WA ZIP: 99352 BUSINESS PHONE: 509-736-4000 MAIL ADDRESS: STREET 1: 719 JADWIN AVENUE CITY: RICHLAND STATE: WA ZIP: 99352 FORMER COMPANY: FORMER CONFORMED NAME: ADVANCED MEDICAL ISOTOPE Corp DATE OF NAME CHANGE: 20081103 4 1 form4-10042021_031024.xml X0306 4 2021-09-23 0001449349 VIVOS INC RDGL 0001486806 Korenko Michael K C/O VIVOS INC 719 JADWIN AVENUE RICHLAND WA 99352 true true false false CEO AND PRESIDENT Common Stock 2021-09-23 4 M 0 150000 0.045 A 10244259 D Common Stock 2021-09-23 4 D 0 58696 0.115 D 10185563 D Warrants 0.045 2021-09-23 4 M 0 150000 0 D 2019-09-24 2021-09-24 Common Stock 150000 0 D On September 23, 2021, the reporting person exercised a warrant to purchase 150,000 shares of the Issuer's common stock. The reporting person paid the exercise price on a cashless basis, resulting in the Issuer's withholding of 58,696 of the warrant shares to pay the exercise price and issuing to the reporting person the remaining 91,304 shares. /s/ Michael K. Korenko 2021-10-04