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