0001493152-21-010934.txt : 20210511 0001493152-21-010934.hdr.sgml : 20210511 20210511061529 ACCESSION NUMBER: 0001493152-21-010934 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210505 FILED AS OF DATE: 20210511 DATE AS OF CHANGE: 20210511 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: 21909527 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 ownership.xml X0306 4 2021-05-05 0 0001449349 VIVOS INC RDGL 0001486806 Korenko Michael K C/O VIVOS INC 719 JADWIN AVENUE RICHLAND, WA 99352 0 1 0 0 CEO AND PRESIDENT Options 0.11 2021-05-05 5 D 0 E 8120152 0 D 2018-10-24 2025-10-24 Common Stock 8120152 0 D The reporting person irrevocably surrendered the options to the Issuer for no consideration. /s/ Michael K. Korenko 2021-05-10