0001144204-15-054138.txt : 20150909
0001144204-15-054138.hdr.sgml : 20150909
20150909084408
ACCESSION NUMBER: 0001144204-15-054138
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150904
FILED AS OF DATE: 20150909
DATE AS OF CHANGE: 20150909
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Xtant Medical Holdings, Inc.
CENTRAL INDEX KEY: 0001453593
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
IRS NUMBER: 205313323
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 664 CRUISER LANE
CITY: BELGRADE
STATE: MT
ZIP: 59714
BUSINESS PHONE: 406-388-0480
MAIL ADDRESS:
STREET 1: 664 CRUISER LANE
CITY: BELGRADE
STATE: MT
ZIP: 59714
FORMER COMPANY:
FORMER CONFORMED NAME: Bacterin International Holdings, Inc.
DATE OF NAME CHANGE: 20100615
FORMER COMPANY:
FORMER CONFORMED NAME: K KITZ INC
DATE OF NAME CHANGE: 20090108
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: WICKWIRE JON M.
CENTRAL INDEX KEY: 0001514546
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-34951
FILM NUMBER: 151098015
MAIL ADDRESS:
STREET 1: 600 CRUISER LANE
CITY: BELGRADE
STATE: MT
ZIP: 59714
4
1
v419969_form4.xml
OWNERSHIP DOCUMENT
X0306
4
2015-09-04
0
0001453593
Xtant Medical Holdings, Inc.
BONE
0001514546
WICKWIRE JON M.
600 CRUISER LANE
BELGRADE
MT
59714
1
0
0
0
Common Stock
2015-09-04
4
P
0
10869
3.68
A
31247
D
Common Stock
23103
I
By Trust
Common Stock
1330
I
By Trust
Common Stock
1329
I
By Trust
/s/ Jon Wickwire
2015-09-08