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