0001387131-21-008879.txt : 20210823 0001387131-21-008879.hdr.sgml : 20210823 20210823162612 ACCESSION NUMBER: 0001387131-21-008879 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210819 FILED AS OF DATE: 20210823 DATE AS OF CHANGE: 20210823 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Medytox Inc. CENTRAL INDEX KEY: 0001848514 STATE OF INCORPORATION: M5 FISCAL YEAR END: 1220 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38381 FILM NUMBER: 211197248 BUSINESS ADDRESS: STREET 1: 78, GANGNI 1-GIL, OCHANG-EUP, STREET 2: CHEONGWON-GU CITY: CHEOGJU-SI STATE: M5 ZIP: 28126 BUSINESS PHONE: 82-2-3471-8319 MAIL ADDRESS: STREET 1: 78, GANGNI 1-GIL, OCHANG-EUP, STREET 2: CHEONGWON-GU CITY: CHEOGJU-SI STATE: M5 ZIP: 28126 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Evolus, Inc. CENTRAL INDEX KEY: 0001570562 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 461385614 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 520 NEWPORT CENTER DRIVE STREET 2: SUITE 1200 CITY: NEWPORT BEACH STATE: CA ZIP: 92660 BUSINESS PHONE: (949) 284-4555 MAIL ADDRESS: STREET 1: 520 NEWPORT CENTER DRIVE STREET 2: SUITE 1200 CITY: NEWPORT BEACH STATE: CA ZIP: 92660 4 1 medytox-form4_081921.xml X0306 4 2021-08-19 0 0001570562 Evolus, Inc. EOLS 0001848514 Medytox Inc. 78, GANGNI 1-GIL, OCHANG-EUP, CHEONGWON-GU CHEONGJU-SI M5 28126 KOREA, REPUBLIC OF 0 0 1 0 Common Stock, $0.00001 par value per share 2021-08-19 4 P 0 55000 10.5111 A 7112652 D Common Stock, $0.00001 par value per share 2021-08-20 4 P 0 48000 10.5562 A 7160652 D /s/ Minjung Choi, Senior Manager, on behalf of Medytox Inc. 2021-08-20